![]() Lactic acidosis is among the most common concerns for those caring for critically ill patients. Medications and toxins that cause lactic acidosis: For example, excessive lactate production from severe convulsions concomitant with impaired hepatic metabolic capabilities such as can occur with cirrhosis, hypothermia, sepsis, severe hypovolemia, severe hypotension, or some combination of these factors, can lead to severe lactic acidosis. That is, there is excessive production of lactate which exceeds the liver’s capacity to metabolize it. Pathologic and persistent lactic acidosis occurs when a combination of two variables coexist. Excess lactate gets shuttled to the liver, to undergo gluconeogenesis. Subsequently, the NAD+ gets utilized in glycolysis to generate two molecules of ATP per molecule of glucose. In the lactic acid cycle, pyruvate is converted to lactate, and NAD+ is regenerated from NADH. However, under anaerobic conditions, pyruvate generated from glycolysis channels into the Cori cycle or lactic acid cycle. Under aerobic conditions, it enters the citric acid cycle after having been converted to acetyl-CoA by pyruvate dehydrogenase, and a series of reactions occur to form ATP and NADH, which goes on to the process of oxidative phosphorylation which produces the majority of ATP in a cell. Pyruvate production as a result of glycolysis gets shunted into two main metabolic pathways. In general, elevated lactate can be the result of increased production, decreased clearance, or both. During heavy exercise, it is the skeletal muscles which produce the most excess circulating lactate, which normalizes in the absence of impaired hepatic metabolism. The tissues which normally produce excess lactic acid include the skin, red cells, brain tissue, muscle, and the gastrointestinal (GI) tract. Some tissues can use lactate as a substrate and oxidize it to carbon dioxide (C02) and water, but only the liver and kidney have the necessary enzymes to utilize lactate for the process of gluconeogenesis. It is then metabolized mostly via the liver and the kidney. For i-STAT test cartridge information and intended use, refer to individual product pages or the cartridge information (CTI/IFU) in the i-STAT Support area.Ībbott - A Leader in Rapid Point-of-Care Diagnostics.Lactic acid is normally produced in excess by about 20 mmol/kg/day, which enters the bloodstream. Check with your local representative for availability in specific markets. Not all products are available in all regions. GDPR Statement | Declaration for California Compliance Law. Any person depicted in such photographs is a model. Photos displayed are for illustrative purposes only. Your use of this website and the information contained herein is subject to our Website Terms and Conditions and Privacy Policy. The products and information contained herewith may not be accessible in all countries, and Abbott takes no responsibility for such information which may not comply with local country legal process, regulation, registration and usage. This website is governed by applicable U.S. No use of any Abbott trademark, trade name, or trade dress in this site may be made without the prior written authorization of Abbott, except to identify the product or services of the company. ![]() Unless otherwise specified, all product and service names appearing in this Internet site are trademarks owned by or licensed to Abbott, its subsidiaries or affiliates.
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