Classification of Some Causes of Lactic Acidosis (Cohen & Woods, 1976)
Type A Lactic Acidosis : Clinical Evidence of Inadequate Tissue Oxygen Delivery
- Anaerobic muscular activity (eg sprinting, generalised convulsions)
- Tissue hypoperfusion (eg shock -septic, cardiogenic or hypovolaemic; hypotension; cardiac arrest; acute heart failure; regional hypoperfusion esp mesenteric ischaemia; malaria8,9)
- Reduced tissue oxygen delivery or utilisation (eg hypoxaemia, carbon monoxide poisoning, severe anaemia)
Type B Lactic Acidosis: No Clinical Evidence of Inadequate Tissue Oxygen Delivery
type B1 : Associated with underlying diseases (eg ketoacidosis, leukaemia, lymphoma, AIDS)
type B2: Assoc with drugs & toxins (eg phenformin, cyanide, beta-agonists, methanol, nitroprusside infusion, ethanol intoxication in chronic alcoholics, anti-retroviral drugs)
type B3: Assoc with inborn errors of metabolism (eg congenital forms of lactic acidosis with various enzyme defects eg pyruvate dehydrogenase deficiency
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