Symptoms of lactic acidosis include rapid breathing, excessive sweating, cool and clammy skin, sweet-smelling breath, belly pain, nausea or vomiting, confusion, and coma. See whether the right amount of oxygen is reaching the body’s tissues. Find the cause for a high amount of acid (low pH) in the blood.

Lactic acidosis occurs when there’s too much lactic acid in your body. Causes can include chronic alcohol use, heart failure, cancer, seizures, liver failure, prolonged lack of oxygen, and low blood sugar. Even prolonged exercise can lead to lactic acid buildup.

There are 2 main types of lactic acidosis, type A and type B; type A is more serious because it is caused by ischemia. Diagnosis requires blood pH < 7.35 and serum lactate levels > 45 to 54 mg/dL (> 5 to 6 mmol/L). Avoid pressors when possible for types A and B lactic acidosis because they worsen tissue ischemia.

In severe cases multiple beta agonist treatments may be required, increasing the potential of inducing a type B lactic acidosis[1,2]. The mechanism for the lactic acidosis is attributed to an increase in pyruvate production as well as inhibition of pyruvate oxidation leading to increased lactate production[1].

The symptoms of lactic acidosis include abdominal or stomach discomfort, decreased appetite, diarrhea, fast, shallow breathing, a general feeling of discomfort, muscle pain or cramping, and unusual sleepiness, tiredness, or weakness. If you have any symptoms of lactic acidosis, get emergency medical help right away.

Type A is lactic acidosis occurring in association with clinical evidence of poor tissue perfusion or oxygenation of blood (eg, hypotension, cyanosis, cool and mottled extremities). It can be caused by the overproduction of lactate or the underutilization of lactate.

However, there have no definite diagnostic criteria, exclusion of other potential etiologies is essentially required. The pathophysiology of salbutamol-induced lactic acidosis is an increase of glycolysis pathway resulting in pyruvate and lactate escalation [1,2,3,4,5].

Very high levels of lactic acid cause a serious, sometimes life-threatening condition called lactic acidosis. Lactic acidosis can also occur in a person who takes metformin (Glucophage) to control diabetes when heart or kidney failure or a severe infection is also present.

A high lactic acid value means lactic acidosis, which can be caused by: Severe loss of water from the blood (dehydration). Blood problems, such as severe anemia or leukemia. Liver disease or liver damage that prevents the liver from breaking down lactic acid in the blood.

Heart problems – There are a number of cardiac conditions and heart problems that can cause elevated lactic acid levels. For example, severe bleeding and shock can lead to higher production of lactic acid, as can severe infections. If there is a blockage of blood flow to your intestines, the result may be an increase in lactic acid.

A tuberculosis medication called isoniazid and a diabetes medication called metformin will both raise your levels of lactic acid. Exercise – Moderate and vigorous exercise can lead to an increase in lactic acid production, but it is usually safe, normal levels.

Sodium nitroprusside, by the method of alleviating regional hypoperfusion, has been suggested for the treatment of some forms of lactic acidosis. Peritoneal dialysis and hemodialysis can be used sometimes for cleansing the blood of lactic acid. Insulin therapy is very useful in phenformin associated lactic acidosis.