Lactic acidosis is best described by which laboratory pattern?

Lactic acidosis is best described by which laboratory pattern?

• A. Increased anion gap with decreased pH, CO2, bicarbonate
• B. Normal anion gap with increased bicarbonate
• C. Decreased anion gap with increased pH
• D. Normal pH with metabolic alkalosis

Answer: (A)

Lactic acidosis shows an elevated anion gap metabolic acidosis. When lactate and other organic acids accumulate, they add unmeasured anions to the serum, increasing the anion gap. The excess hydrogen ions lower the pH, so acidity rises. To buffer this acidosis, bicarbonate is used up, causing a drop in bicarbonate levels. The body compensates by hyperventilating, which lowers the CO2 level. So the typical lab pattern is a high anion gap with decreased pH, decreased bicarbonate, and decreased CO2. This doesn’t fit patterns with a normal anion gap or with alkalosis or with normal pH, which would indicate different acid–base disturbances.

Lactic acidosis shows an elevated anion gap metabolic acidosis. When lactate and other organic acids accumulate, they add unmeasured anions to the serum, increasing the anion gap. The excess hydrogen ions lower the pH, so acidity rises. To buffer this acidosis, bicarbonate is used up, causing a drop in bicarbonate levels. The body compensates by hyperventilating, which lowers the CO2 level. So the typical lab pattern is a high anion gap with decreased pH, decreased bicarbonate, and decreased CO2.

This doesn’t fit patterns with a normal anion gap or with alkalosis or with normal pH, which would indicate different acid–base disturbances.