Lactic Acidosis

Posted by e-Medical PPT
Lactic acidosis is a physiological condition characterized by low pH in body tissues and blood  accompanied by the buildup of lactate especially D-lactate, and is considered a distinct form of metabolic acidosis.The condition typically occurs when cells receive too little oxygen (hypoxia), for example during vigorous exercise.If oxygen supply is inadequate (hypoxia), the mitochondria are unable to continue ATP synthesis at a rate sufficient to supply the cell with the required ATP. In this situation, glycolysis is increased to provide additional ATP, and the excess pyruvate produced is converted into lactate and released from the cell into the bloodstream, where it accumulates over time. While increased glycolysis helps compensate for less ATP from oxidative phosphorylation, it cannot bind the protons resulting from ATP hydrolysis. Therefore, proton concentration rises and causes acidosis.Lactic acidosis is characterized by lactate levels more than 5 mmol/L and serum pH less than 7.35.
The signs of lactic acidosis are deep and rapid breathing, vomiting, and abdominal pain—symptoms that may easily be mistaken for other problems.
Lactic acidosis may be caused by diabetic ketoacidosis or liver or kidney disease, as well as some forms of medication (notably the anti-diabetic drugs phenformin and metformin). Some anti-HIV drugs (antiretrovirals) warn doctors in their prescribing information to regularly watch for symptoms of lactic acidosis caused by mitochondrial toxicity. Heavy metal toxicity, including arsenic poisoning can raise lactate levels and lead to generalized metabolic acidosis as well.


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