endocrine and metabolic disorders
Lactic Acidosis
Diagnosis of Lactic Acidosis
Arterial blood gas (ABG) and serum electrolyte measurements Anion gap and delta gap calculated Blood lactate level ABG values in types A and B lactic acidosis are as for other Diagnosis . Diagnosis requires blood pH < 7.35 and lactate > 45 to 54 mg/dL (> 5 to 6 mmol/L). Less extreme lactate and pH changes are referred to as hyperlacticemia. In D-lactic acidosis, the anion gap is lower than expected for the decrease in bicarbonate (HCO3−), and there may be a urinary osmolar gap (difference between calculated and measured urine osmolarity). Typical laboratory lactate assays are not sensitive to D-lactate. Specific D-lactate levels are available and are sometimes needed to clarify the cause of acidosis in patients with multiple potential causes, including bowel problems. 