Survival after extreme arterial acidosis is uncommon. A case of metformin induced lactic acidosis is described where the presenting pH was 6.38 exacerbated by hypothermia (29 degrees C). Increased anion gap acidosis, its varied aetiology, potential reversibility, and the role of hypothermia are discussed. Early liaison with a medical toxicology unit is recommended when this rare condition is su...

Lactic acidosis is a commonly observed clinical condition that is associated with a poor prognosis, especially in malignancies. We describe a case of an 81-year-old patient who presented with symptoms of tachypnea and general discomfort. Arterial blood gas analysis showed a high anion gap acidosis with a lactate level of 9.5 mmol/L with respiratory compensation. CT scanning showed no signs of p...

Lactic acidosis is a rare but often fatal complication reported in some human immunodeficiency virus (HIV)-infected patients treated with nucleoside-analogue reverse-transcriptase inhibitors. We report a series of 12 patients with HIV infection treated with nucleoside analogues who developed unexplained metabolic acidosis. We have also reviewed 60 additional published cases. The aim of the pres...

Rations containing approximately 85% ground high-moisture, ensiled corn were fed to steers in such a way as to produce lactic acid acidosis, and three dietary buffers were evaluated in regard to their effect on ruminal and systemic acidosis. The buffers consisted of (1) 2% sodium bentonite, (2) 1% sodium bentonite plus 1% dolomitic limestone, and (3) 1% sodium bentonite plus 1% potassium bicarb...

D-lactic acidosis or D-lactate encephalopathy is a rare condition that occurs primarily in individuals who have a history of short bowel syndrome. The unabsorbed carbohydrates act as a substrate for colonic bacteria to form D-lactic acid among other organic acids. The acidic pH generated as a result of D-lactate production further propagates production of D-lactic acid, hence giving rise to a v...

Two trials were conducted to study ruminal lactic acid, histamine, tyramine and tryptamine concentrations following glucose engorgement in vitro and in vivo. Also, electrolyte changes in rumen fluid, blood plasma and urine during lactic acidosis were examined. Experiment 1 involved the addition of glucose to rumen fluid in vitro. After 30 hr of incubation, decreases in pH and increases in lacti...

Metformin, a widely used anti-diabetic agent of the biguanide family, although generally safe, holds the risk of developing a potentially lethal acidosis. The association between lactic acidosis and metformin is well-established but rarely seen in patients taking this medication. Its elimination relies solely on kidneys’ excretion, so its accumulation is feasible in just two circumstances: rena...

OBJECTIVES To critically discuss the treatment of metabolic acidosis and the main mechanisms of disease associated with this disorder; and to describe controversial aspects related to the risks and benefits of using sodium bicarbonate and other therapies. SOURCES Review of PubMed/MEDLINE, LILACS and Cochrane Library databases for articles published between 1996 and 2006 using the following ke...

Bovine ruminal acidosis is of economic importance as it contributes to reduced milk and meat production. This phenomenon is mainly attributed to an overload of highly fermentable carbohydrate, resulting in increased d(-) lactic acid levels in serum and plasma. Ruminal acidosis correlates with elevated acute phase proteins in blood, along with neutrophil activation and infiltration into various ...