HYPERLACTATAEMIA. Aetiology
Anaerobic causes ◆ Macrocirculatory shock. ◆ Microcirculatory shunting. ◆ Carbon monoxide poisoning (carboxyhaemoglobin). Aerobic causes ◆ Increased aerobic glycolysis: • Catecholamine-stimulated increased Na+–K+-pump activity. • Cytokine-mediated glucose uptake. ◆ Mitochondrial dysfunction. ◆ Pyruvate dehydrogenase dysfunction: • Sepsis. • Thiamine deficiency. ◆ Reduced clearance: • Liver insufficiency/surgery. • Sepsis. ◆ Alkalosis. ◆ Malignancy (Warburg effect). ◆ Epileptic seizure (grand mal). ◆ Congenital metabolic diseases. ◆ Drugs and intoxications: • Nucleoside reverse transcriptase inhibitors. • Epinephrine. • Metformin. • Propofol (propofol infusion syndrome). • Corticosteroids. • Cyanide. • Ethylene glycol. • Methanol. • Carbon monoxide po...