Meegada Sreenath, Muppidi Vijayadershan, Siddamreddy Suman, Challa Tejo, Katta Shravan K
Internal Medicine, University of Texas Health Science Center/Christus Good Shepherd Medical Center, Longview, USA.
Internal Medicine, Indiana University Health, Indianapolis, USA.
Cureus. 2020 May 25;12(5):e8269. doi: 10.7759/cureus.8269.
Lactic acidosis (LA) is usually a medical emergency diagnosed by laboratory evaluation in emergency rooms (ERs) and hospital settings in critically ill patients. LA is classified into two major types based on pathophysiology; type A results from tissue hypoxia and/or hypoperfusion and type B results from deranged metabolic activity in the cells in the absence of hypoxia/hypoperfusion. Prompt evaluation and treatment are essential to prevent morbidity and mortality, especially in patients with type A LA. Most cases of LA are due to type A (hypoperfusion/hypoxia). However, with increased testing of lactic acid levels in ERs and hospitals, we are encountering a few cases of type B LA as well. Diagnosing the exact type is crucial because of differences in management. We here describe a patient with albuterol-induced type B LA, which resolved after discontinuing the albuterol breathing treatments.
乳酸性酸中毒(LA)通常是一种医疗急症,在急诊室(ER)和医院环境中,通过对重症患者进行实验室评估来诊断。根据病理生理学,LA分为两种主要类型;A型是由组织缺氧和/或灌注不足引起的,B型是在无缺氧/灌注不足的情况下,细胞代谢活动紊乱所致。及时评估和治疗对于预防发病和死亡至关重要,尤其是对于A型LA患者。大多数LA病例是由A型(灌注不足/缺氧)引起的。然而,随着急诊室和医院对乳酸水平检测的增加,我们也遇到了一些B型LA病例。由于管理上的差异,准确诊断具体类型至关重要。我们在此描述一名因使用沙丁胺醇诱发B型LA的患者,在停止沙丁胺醇呼吸治疗后病情得到缓解。