Abstract
Lactic acidosis is a clinical entity that demands rapid assessment and treatment to prevent significant morbidity and mortality. With increased lactate use across many clinical scenarios, lactate values themselves cannot be interpreted apart from their appropriate clinical picture. The significance of Type B lactic acidosis is likely understated in the emergency department (ED). Given the mortality that sepsis confers, a serum lactate is an important screening study. That said, it is with extreme caution that we should interpret and react to the resultant elevated value. We report a patient with a significant lactic acidosis. Though he had a high lactate value, he did not require aggressive resuscitation. A different classification scheme for lactic acidosis that focuses on the bifurcation of the “dangerous” and “not dangerous” causes of lactic acidosis may be of benefit. In addition, this case is demonstrative of the potential overuse of lactates in the ED.
Highlights
Given that increased lactate values are unequivocally associated with higher likelihoods of in-hospital mortality across many clinical scenarios, emergency physicians globally are being faced with attributing a lactate value to either a potentially devastating or not-devastating etiology
We report a patient with a significant lactic acidosis
CASE REPORT We report the case of a 50-year-old male who presented to the emergency department (ED) complaining of dyspnea
Summary
Lactic acidosis is a clinical entity that demands rapid assessment and treatment to prevent significant morbidity and mortality. The significance of Type B lactic acidosis is likely understated in the emergency department (ED). We report a patient with a significant lactic acidosis. Though he had a high lactate value, he did not require aggressive resuscitation. A different classification scheme for lactic acidosis that focuses on the bifurcation of the “dangerous” and “not dangerous” causes of lactic acidosis may be of benefit. This case is demonstrative of the potential overuse of lactates in the ED. This case is demonstrative of the potential overuse of lactates in the ED. [Clin Pract Cases Emerg Med.2018;2(2):128-131.]
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