- Type A lactic acidosis – Associated with tissue hypoperfusion resulting in hypovolemia, cardiac failure, sepsis, or cardiopulmonary arrest. Patients typically present with hypotension, cool and clammy extremities, oliguria, and altered mental status.
- Type B lactic acidosis – Evidence of systemic hypoperfusion is not readily apparent with acidosis possibly secondary to toxin-induced impairment of cellular metabolism or regional areas of ischemia. Common causes include diabetes, malignancies such as leukemia, lymphoma, or solid tumors, chronic severe alcohol use disorder due to impaired hepatic metabolism of lactate, drug-induced mitochondrial dysfunction due to high doses of propofol, human immunodeficiency virus nucleoside reverse transcriptase inhibitors, and linezolid.
- D-lactic acidosis – Occurs in patients with short gut syndrome or malabsorption due to bacterial fermentation of large amounts of glucose and starch to organic acids, including D-lactic acid. Because of slow metabolism of D-lactic acid, systemic absorption leads to elevated plasma D-lactic acid levels and metabolic acidosis. Other causes include diabetic ketoacidosis and rapid high-dose infusion of propylene glycol in intravenous medications.
E87.2 – Acidosis
91273001 – Lactic Acidosis