Last reviewed 03/2023
Lactic acidosis should be suspected in a patient with a metabolic acidosis and a large anion gap which cannot be explained by:
- ethylene glycol
A lactate level of > 5.0 mM is considered diagnostic.
Incidentally, phosphate levels are usually high in lactic acidosis, averaging 2.9 mM.
Special investigations in type B lactic acidosis aim to determine the underlying condition:
- blood is taken for:
- full blood count, electrolytes and urea
- glucose determination
- serum amylase
- serum calcium
- blood gases
- group and save (in case there is unsuspected hypovolaemia)
- microscopy and culture of urine