Causes of increased lactate
Last reviewed: 23.04.2024
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The increase in lactate concentration reflects the degree of tissue ischemia. The content of lactate in the blood under hypoxic conditions increases according to the severity of hypoxia. The accumulation of lactate is one of the causes of coma, in particular hyperlactacidemic diabetic coma.
There are the following types of lactate (lactate-acidosis) in the blood.
- Type I: lactate concentration increased, marked acidosis absent, lactate / pyruvate ratio normal. This type is identified with physical exertion, hyperventilation, glucagon action, glycogenoses, severe anemia, administration of pyruvate or insulin.
- Type IIA (associated with hypoxia): marked acidosis, lactate concentration increased, lactate / pyruvate ratio increased. This type is revealed in any conditions with inadequate oxygen delivery to tissues (acute bleeding, severe acute congestive heart failure, heart disease with cyanosis or other cases of acute hypoxia, extracorporeal circulation).
- Type IIB (idiopathic): lactate concentration increased, acidosis from moderate to severe, lactate / pyruvate ratio increased. This type is observed with mild uremia, infections (especially pyelonephritis), liver cirrhosis, pregnancy (III trimester), severe vascular disease, leukemia, anemia, alcoholism, subacute infectious endocarditis, poliomyelitis, diabetes (approximately 50% of cases).
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