Lactic acidosis classification: Difference between revisions
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{{Lactic acidosis}} | {{Lactic acidosis}} | ||
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== Overview == | |||
Lactic acidosis is classified as type A and type B according to the root cause being either a shortage of oxygen or other metabolic/acquired factors respectively. | |||
==Classification== | ==Classification== | ||
The Cohen-Woods classification (1976) categorizes causes of lactic acidosis as follows: | [https://docs.google.com/viewer?url=https%3A%2F%2Fcore.ac.uk%2Fdownload%2Fpdf%2F82430305.pdf The Cohen-Woods classification (1976)] categorizes causes of lactic acidosis as follows: | ||
* Type A: Decreased perfusion or oxygenation | |||
* Type B: | *Type A: Decreased perfusion or oxygenation: Occurs due to an oxygen demand/supply mismatch, causing [[Glycolysis|anaerobic glycolysis]]. Examples include all shock states ([[Septic Shock|septic]], [[Cardiogenic shock|cardiogenic]], [[Hypovolemic shock|hypovolemic]], [[Obstructive shock|obstructive]]), regional ischemia (limb, mesenteric), seizures/convulsions, and severe cases of shivering. | ||
** B1: Underlying diseases (sometimes causing type A) | *Type B: Defined as not having to do with tissue hypoxia or hypoperfusion. | ||
** B2: Medication or intoxication | **B1: Underlying diseases (sometimes causing type A) such as liver disease, malignancy, [[HIV AIDS|HIV]], [[thiamine deficiency]], [[Diabetic ketoacidosis|diabetic ketoacidosis.]] | ||
** B3: [[Inborn error of metabolism]] | **B2: Medication or intoxication example [[metformin]], [[epinephrine]], [[total parenteral nutrition]], [[ethanol]]. | ||
**B3: [[Inborn error of metabolism]], such as [[mitochondrial myopathy]], congenital lactic acidosis. | |||
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==References== | ==References== | ||
Latest revision as of 11:27, 15 December 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saud Khan M.D.
Overview
Lactic acidosis is classified as type A and type B according to the root cause being either a shortage of oxygen or other metabolic/acquired factors respectively.
Classification
The Cohen-Woods classification (1976) categorizes causes of lactic acidosis as follows:
- Type A: Decreased perfusion or oxygenation: Occurs due to an oxygen demand/supply mismatch, causing anaerobic glycolysis. Examples include all shock states (septic, cardiogenic, hypovolemic, obstructive), regional ischemia (limb, mesenteric), seizures/convulsions, and severe cases of shivering.
- Type B: Defined as not having to do with tissue hypoxia or hypoperfusion.
- B1: Underlying diseases (sometimes causing type A) such as liver disease, malignancy, HIV, thiamine deficiency, diabetic ketoacidosis.
- B2: Medication or intoxication example metformin, epinephrine, total parenteral nutrition, ethanol.
- B3: Inborn error of metabolism, such as mitochondrial myopathy, congenital lactic acidosis.