Critical Care Time 53. Lactate & Lactic Acidosis
46 snips
Jul 14, 2025 Dive into the fascinating world of lactic acidosis! Understand the crucial role lactate plays in energy metabolism and the clinical implications of high levels in critical care. Learn about the distinctions between type A and type B lactic acidosis and their causes, including medication effects. Explore the importance of monitoring lactate levels and the complexities of diagnosing underlying issues. You'll gain valuable insights into managing this critical condition effectively!
AI Snips
Chapters
Transcript
Episode notes
PDH and LDH Define Metabolic Fate
- Pyruvate dehydrogenase (PDH) directs pyruvate to aerobic metabolism when oxygen is plentiful.
- When oxygen is scarce, lactate dehydrogenase (LDH) converts pyruvate to lactate to regenerate NAD+ and sustain glycolysis.
Lactate Balance: Production and Clearance
- Lactate levels reflect a balance between production and clearance.
- The liver clears about 70% of lactate; liver or kidney failure impairs clearance raising lactate levels.
Types of Lactic Acidosis Explained
- Lactic acidosis is classified into types A (impaired oxygen delivery), B (impaired oxygen utilization), and D (bacterial overgrowth).
- Types A and B cover most clinical cases; Type D is rare and related to bacterial metabolism.