720:. As more lactate accumulates and rumen pH drops, the ruminal concentration of undissociated lactic acid increases. Undissociated lactic acid can cross the rumen wall to the blood, where it dissociates, lowering blood pH. Both L and D isomers of lactic acid are produced in the rumen; these isomers are metabolized by different metabolic pathways, and activity of the principal enzyme involved in metabolism of the D isomer declines greatly with lower pH, tending to result in an increased ratio of D:L isomers as acidosis progresses.
69:
43:
648:) for intense movements, can be particularly susceptible to lactic acidosis. In particular, during the capture of large crocodiles, the animals' use of their glycolytic muscles often alters the blood's pH to a point where they are unable to respond to stimuli or move. Cases are recorded in which particularly large crocodiles which put up extreme resistance to capture later died of the resulting pH imbalance.
724:
or monensin in feed can reduce risk of lactic acidosis in ruminants, inhibiting most of the lactate-producing bacterial species without inhibiting the major lactate fermenters. Also, using a higher feeding frequency to provide the daily grain ration can allow higher grain intake without reducing the pH of the rumen fluid.
723:
Measures for preventing lactic acidosis in ruminants include avoidance of excessive amounts of grain in the diet, and gradual introduction of grain over a period of several days, to develop a rumen population capable of safely dealing with a relatively high grain intake. Administration of lasalocid
685:
In domesticated ruminants, lactic acidosis may occur as a consequence of ingesting large amounts of grain, especially when the rumen population is poorly adapted to deal with grain. Activity of various rumen organisms results in accumulation of various volatile fatty acids (normally, mostly acetic,
78:
Lactic
Acidosis refers to the process leading to the production of lactate by anaerobic metabolism. It increases hydrogen ion concentration tending to the state of acidemia or low pH. The result can be detected with high levels of lactate and low levels of bicarbonate. This is usually considered the
459:
in ten enzymatic steps. A significant proportion of pyruvate is converted into lactate (the blood lactate-to-pyruvate ratio is normally 10:1). The human metabolism produces about 20 mmol/kg of lactic acid every 24 hours. This happens predominantly in tissues (especially muscle) that have high
499:
In "type A" lactic acidosis, the production of lactate is attributable to insufficient oxygen for aerobic metabolism. If there is no oxygen available for the parts of the glucose metabolism that require oxygen (citric acid cycle and oxidative phosphorylation), excess pyruvate will be converted in
727:
Treatment of lactic acidosis in ruminants may involve intravenous administration of dilute sodium bicarbonate, oral administration of magnesium hydroxide, and/or repeated removal of rumen fluids and replacement with water (followed by reinoculation with rumen organisms, if necessary).
715:
Because of the high solute concentration of the rumen fluid under such conditions, considerable water is translocated from the blood to the rumen along the osmotic potential gradient, resulting in dehydration which cannot be relieved by drinking, and which can ultimately lead to
670:. This precipitate is suggested to be reabsorbed by the shell and skeleton, thereby removing it from the bloodstream; studies examining turtles that have been subjected to prolonged anoxic conditions have up to 45% of their lactate stored within their skeletal structure.
563:
Lactic acidosis is classically defined as an elevated lactate together with pH < 7.35 and bicarbonate below 20 mmol/L, but this is not required as lactic acidosis may exist together with other acid-base abnormalities that may affect these two parameters.
495:
Elevations in lactate are either a consequence of increased production or of decreased metabolism. With regards to metabolism, this predominantly takes place in the liver (70%), which explains that lactate levels may be elevated in the setting of liver disease.
1161:
McKenzie, Robin; Fried, Michael W.; Sallie, Richard; Conjeevaram, Hari; Di
Bisceglie, Adrian M.; Park, Yoon; Savarese, Barbara; Kleiner, David; Tsokos, Maria; Luciano, Carlos; Pruett, Timothy; Stotka, Jennifer L.; Straus, Stephen E.; Hoofnagle, Jay H. (1995).
1887:
1872:
1857:
239:
500:
excess lactate. In "type B" lactic acidosis the lactate accumulates because there is a mismatch between glycolysis activity and the remainder of glucose metabolism. Examples are situations where the
696:
and some other organisms. With high grain consumption, the concentration of dissociated organic acids can become quite high, resulting in rumen pH dropping below 6. Within this lower pH range,
662:
to provide the majority of their energy needs. Adaptations in particular in the turtle's blood composition and shell allow it to tolerate high levels of lactic acid accumulation. In the
1120:"Triumeq (Abacavir, Dolutegravir, and Lamivudine Film-coated Tablets) Drug Information: Description, User Reviews, Drug Side Effects, Interactions – Prescribing Information at RxList"
845:
Baertling, F; Rodenburg, R. J; Schaper, J; Smeitink, J. A; Koopman, W. J. H; Mayatepek, E; Morava, E; Distelmaier, F (2013). "A guide to diagnosis and treatment of Leigh syndrome".
666:
conditions where fermentation is dominant, calcium levels in the blood plasma increase. This calcium serves as a buffer, reacting with the excess lactate to form the precipitate
508:). There is controversy as to whether elevated lactate in acute illness can be attributed to tissue hypoxia; there is limited empirical support for this theoretical notion.
281:(MALA) increases in certain situations where both the plasma levels of metformin are increased and lactate clearance is impaired. The older related and now withdrawn drug
686:
propionic, and butyric acids), which are partially dissociated. Although some lactate is normally produced in the rumen, it is normally metabolized by such organisms as
888:
Santini, A; Ronchi, D; Garbellini, M; Piga, D; Protti, A (July 2017). "Linezolid-induced lactic acidosis: the thin line between bacterial and mitochondrial ribosomes".
468:
into lactate. The lactate is carried by the bloodstream to other tissues where it is converted back to pyruvate by the "B" isoform of LDH (LDHB). Firstly there is
625:
Mild and transient elevations in lactate have limited impact on mortality, whereas sustained and severe lactate elevations are associated with a high mortality.
1987:
1811:
Kaufmann W (1976). "Influence of the composition of the ration and the feeding frequency on ph-regulation in the rumen and on feed in-take in ruminants".
524:
is also available as an alternative as they are effectively interchangeable. Normally resulting lactate concentrations are in the range indicated below:
712:
of lactic acid is low, about 3.9, versus, for example, 4.8 for acetic acid; this contributes to the considerable drop in rumen pH which can occur.
651:
Certain turtle species have been found to be capable of tolerating high levels of lactic acid without experiencing the effects of lactic acidosis.
1453:
Kajbaf, F; Lalau, JD (November 2014). "Mortality rate in so-called "metformin-associated lactic acidosis": a review of the data since the 1960s".
628:
The mortality of lactic acidosis in people taking metformin was previously reported to be 50%, but in more recent reports this was closer to 25%.
472:
in the liver (as well as the kidney and some other tissues), where lactate is converted into pyruvate and then into glucose; this is known as the
176:
109:
samples), and once confirmed, generally prompts an investigation to establish the underlying cause to treat the acidosis. In some situations,
1735:
Nagaraja, TG; Avery, TB; Bartley, EE; Galitzer, SJ; Dayton, AD (1981). "Prevention of lactic acidosis in cattle by lasalocid or monensin".
2154:
171:
Lactic acidosis is commonly found in people who are unwell, such as those with severe heart and/or lung disease, a severe infection with
2128:
1252:
Garcia-Alvarez, Mercedes; Marik, Paul; Bellomo, Rinaldo (April 2014). "Stress hyperlactataemia: present understanding and controversy".
79:
result of illness but also results from strenuous exercise. The effect on pH is moderated by the presence of respiratory compensation.
1296:
224:
2021:
1980:
754:
244:
318:
313:
229:
90:
medical condition, medication, or poisoning. The symptoms are generally attributable to these underlying causes, but may include
1164:"Hepatic Failure and Lactic Acidosis Due to Fialuridine (FIAU), an Investigational Nucleoside Analogue for Chronic Hepatitis B"
249:
210:
591:
or dialysis) is difficult, with limited evidence for benefit; it may not be possible to keep up with the lactate production.
219:
708:
are inhibited, tending to result in a considerable rise of lactate and hydrogen ion concentrations in the rumen fluid. The
572:
If elevated lactate is present in acute illness, supporting the oxygen supply and blood flow are key initial steps. Some
1973:
138:
1523:
1023:"Phenformin-Induced Lactic Acidosis in an Older Diabetic Patient: A recurrent drama (phenformin and lactic acidosis)"
1602:
Kimberling, C. V. 1988. Jensen and Swift's diseases of sheep. 3rd Ed. Lea & Fibiger, Philadelphia. 394 pp.
1312:
Boyd, JH; Walley, KR (Aug 2008). "Is there a role for sodium bicarbonate in treating lactic acidosis from shock?".
709:
581:
501:
158:
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may be used. The prognosis of lactic acidosis depends largely on the underlying cause; in some situations (such as
2133:
2048:
489:
1902:
659:
577:
1697:
1642:
Van Soest, P. J. 1994. Nutritional ecology of the ruminant. 2nd Ed. Cornell Univ. Press, Ithaca. 476 pp.
598:
solutions to improve the pH (which is associated with increased carbon dioxide generation and may reduce the
2053:
692:
517:
323:
1996:
2058:
2036:
485:
206:
682:
livestock, the cause of clinically serious lactic acidosis is different from the causes described above.
2112:
2105:
2031:
614:
573:
461:
391:
269:
114:
113:(purification of the blood) is temporarily required. In rare chronic forms of lactic acidosis caused by
1630:
Kahn, C. M. (ed.) 2005. Merck veterinary manual. 9th Ed. Merck & Co., Inc., Whitehouse
Station.
1866:
2078:
2070:
432:
418:
352:
358:
Impaired delivery of oxygen to cells in the tissues (e.g., from impaired blood flow (hypoperfusion))
68:
2100:
1891:
1404:
Pfeffer, G; Majamaa, K; Turnbull, DM; Thorburn, D; Chinnery, PF (2012). Chinnery, Patrick F (ed.).
610:
381:
348:
134:
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buried in mud or underwater and do not resurface for the entire winter. As a result, they rely on
2013:
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180:
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57:
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Darmon, Michael; Malak, Sandra; Guichard, Isabelle; Schlemmer, Benoit (July–September 2008).
576:(drugs that augment the blood pressure) are less effective when lactate levels are high, and
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Lactic acidosis caused by inherited mitochondrial disorders (type B3) may be treated with a
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83:
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62:
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1064:"Epinephrine-induced lactic acidosis in orthognathic surgery: a report of two cases"
917:
874:
42:
2026:
1421:
521:
397:
366:
277:: this risk is low (less than 10 cases for 100,000 patient years), but the risk of
1497:
1063:
998:
981:
901:
833:
516:
Acid-base disturbances such as lactic acidosis are typically first assessed using
191:(nausea, vomiting, generalized muscle weakness, and laboured and deep breathing).
1907:
1562:
1325:
1079:
1937:
1772:"Effects of lasalocid or monensin on lactate-producing or -using rumen bacteria"
1180:
1163:
1062:
Son, Hee-Won; Park, Se-Hun; Cho, Hyun-Oh; Shin, Yong-Joon; Son, Jang-Ho (2016).
828:
717:
338:
299:
184:
50:
17:
1918:
1372:
982:"Metformin-associated lactic acidosis: Current perspectives on causes and risk"
1881:
793:
Kraut, Jeffrey A.; Madias, Nicolaos E. (11 December 2014). "Lactic
Acidosis".
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477:
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452:
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361:
310:
282:
1547:"Hibernating without oxygen: physiological adaptations of the painted turtle"
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1357:"Role of dichloroacetate in the treatment of genetic mitochondrial diseases"
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105:
The diagnosis is made on biochemical analysis of blood (often initially on
1797:
1756:
1721:
1682:
1189:
1143:
806:
240:
Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes
2004:
1713:
1119:
679:
641:
465:
456:
294:
95:
1849:
933:"Understanding lactic acidosis in paracetamol (acetaminophen) poisoning"
1965:
145:
Type A: Decreased tissue oxygenation (e.g., from decreased blood flow)
1876:
1861:
1466:
505:
414:
376:
214:
172:
122:
91:
1496:
Seymour R. S.; Webb G. J. W.; Bennett A. F.; Bradford D. F. (1987).
1068:
Journal of the Korean
Association of Oral and Maxillofacial Surgeons
476:. In addition, pyruvate generated from lactate can be oxidized to
437:
D-lactic acidosis due to intestinal bacterial flora production in
1969:
1616:
Pugh, D. G. 2002. Sheep and goat medicine. Saunders. 468 pp.
980:
DeFronzo, R; Fleming, GA; Chen, K; Bicsak, TA (February 2016).
1507:. In Webb, G. J. W.; Manolis, S. C.; Whitehead, P. J. (eds.).
700:
spp. (producing lactate and hydrogen ions) are favored, and
1021:
Fimognari, F. L.; Pastorelli, R.; Incalzi, R. A. (2006).
199:
The several different causes of lactic acidosis include:
141:
classification categorizes causes of lactic acidosis as:
82:
Lactic acidosis is typically the result of an underlying
644:, which rely primarily on anaerobic energy metabolism (
1355:
Stacpoole, PW; Kurtz, TL; Han, Z; Langaee, T (2008).
1839:
1498:"Chapter 26. Effect of capture on the physiology of
1205:"Acute tumor lysis syndrome: a comprehensive review"
2121:
2091:
2069:
2012:
2003:
1928:
1843:
1696:Owens, FN; Secrist, DS; Hill, WJ; Gill, DR (1998).
847:
Journal of
Neurology, Neurosurgery & Psychiatry
747:
Clinical and biochemical aspects of lactic acidosis
587:Direct removal of lactate from the body (e.g. with
56:
35:
788:
786:
187:. Symptoms in humans include all those of typical
151:B1: Underlying diseases (sometimes causing type A)
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1638:
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931:Shah, AD; Wood, DM; Dargan, PI (January 2011).
102:(laboured and deep), and generalised weakness.
1770:Dennis, SM; Nagaraja, TG; Bartley, EE (1981).
1509:Wildlife Management: Crocodiles and Alligators
1287:Goldman, Lee; Schafer, Andrew (May 11, 2015).
285:carried a much higher risk of lactic acidosis.
1981:
8:
1657:"Bovine acidosis: implications on laminitis"
1650:
1648:
455:, in which the molecule is broken down into
125:), it indicates an increased risk of death.
1626:
1624:
1622:
1612:
1610:
1608:
1410:The Cochrane Database of Systematic Reviews
745:Woods, Hubert Frank; Cohen, Robert (1976).
613:(DCA), although this may be complicated by
2009:
1988:
1974:
1966:
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1511:. Sydney: Surrey Beatty. pp. 253–257.
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41:
32:
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1095:
1038:
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956:
937:British Journal of Clinical Pharmacology
526:
460:levels of the "A" isoform of the enzyme
1406:"Treatment for mitochondrial disorders"
1254:The Lancet Diabetes & Endocrinology
1209:Revista Brasileira de Terapia Intensiva
737:
177:systemic inflammatory response syndrome
1144:"Truvada Advanced Patient Information"
225:Fructose 1,6-bisphosphatase deficiency
986:Metabolism: Clinical and Experimental
594:Limited evidence supports the use of
464:(LDHA), which predominantly converts
7:
1455:Pharmacoepidemiology and Drug Safety
2129:Mixed disorder of acid-base balance
270:Paracetamol/acetaminophen poisoning
1040:10.2337/diacare.29.04.06.dc06-0012
25:
1674:10.3168/jds.S0022-0302(97)76026-0
584:can elevate the lactate further.
279:metformin-induced lactic acidosis
245:Pyruvate dehydrogenase deficiency
1314:Current Opinion in Critical Care
949:10.1111/j.1365-2125.2010.03765.x
749:. Oxford: Blackwell Scientific.
319:Abacavir/dolutegravir/lamivudine
314:reverse-transcriptase inhibitors
230:Glucose-6-phosphatase deficiency
213:, or nongenetic deficiencies of
1222:10.1590/S0103-507X2008000300011
1168:New England Journal of Medicine
795:New England Journal of Medicine
451:Glucose metabolism begins with
250:Pyruvate carboxylase deficiency
211:multiple carboxylase deficiency
1698:"Acidosis in cattle: a review"
1422:10.1002/14651858.CD004426.pub3
1361:Advanced Drug Delivery Reviews
617:and has a weak evidence base.
504:is highly active (e.g. severe
403:Regional hypoperfusion (e.g.,
220:Diabetes mellitus and deafness
154:B2: Medication or intoxication
1:
1266:10.1016/S2213-8587(13)70154-2
999:10.1016/j.metabol.2015.10.014
902:10.1080/14740338.2017.1335305
890:Expert Opinion on Drug Safety
179:due to another cause, severe
1825:10.1016/0301-6226(76)90028-2
1563:10.1113/jphysiol.2002.024729
1326:10.1097/MCC.0b013e3283069d5c
1080:10.5125/jkaoms.2016.42.5.295
1545:Jackson, Donald C. (2002).
1530:. Accessed 31 January 2009.
1181:10.1056/NEJM199510263331702
27:Metabolic medical condition
2171:
1373:10.1016/j.addr.2008.02.014
582:beta-2 adrenergic receptor
502:sympathetic nervous system
159:Inborn error of metabolism
1776:Journal of Animal Science
1737:Journal of Animal Science
1702:Journal of Animal Science
1551:The Journal of Physiology
1291:(25 ed.). Elsevier.
690:and, to a lesser extent,
490:oxidative phosphorylation
49:
40:
859:10.1136/jnnp-2012-304426
829:MedlinePlus Encyclopedia
660:lactic acid fermentation
518:arterial blood gas tests
185:depletion of body fluids
1789:10.2527/jas1981.522418x
1749:10.2527/jas1981.531206x
693:Selenomonas ruminantium
324:Emtricitabine/tenofovir
2155:Acid–base disturbances
2037:Alcoholic ketoacidosis
1289:Goldman-Cecil Medicine
480:, which can enter the
387:Advanced liver disease
207:Biotinidase deficiency
2134:Acid–base homeostasis
2106:Contraction alkalosis
2032:Diabetic ketoacidosis
807:10.1056/NEJMra1309483
615:peripheral neuropathy
462:lactate dehydrogenase
392:Diabetic ketoacidosis
117:, a specific diet or
115:mitochondrial disease
1714:10.2527/1998.761275x
1655:Nocek J. E. (1997).
688:Megasphaera elsdenii
433:Tumor lysis syndrome
396:Excessive exercise (
1997:Acid–base disorders
1813:Livestock Prod. Sci
580:that stimulate the
351:(especially during
349:Thiamine deficiency
307:(D-lactic acidosis)
203:Genetic conditions
1929:External resources
1526:2009-05-02 at the
1500:Crocodylus porosus
1367:(13–14): 1478–87.
609:and possibly with
596:sodium bicarbonate
439:short gut syndrome
189:metabolic acidosis
167:Signs and symptoms
107:arterial blood gas
100:Kussmaul breathing
2142:
2141:
2087:
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1963:
1962:
801:(24): 2309–2319.
718:hypovolemic shock
561:
560:
482:citric acid cycle
423:Burkitt lymphomas
333:cyanide poisoning
329:Potassium cyanide
123:severe infections
76:
75:
51:L-(+)-lactic acid
30:Medical condition
16:(Redirected from
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372:Ethanol toxicity
305:Propylene glycol
235:GRACILE syndrome
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18:Acidosis, lactic
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653:Painted turtles
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447:Pathophysiology
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181:physical trauma
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2061:
2056:
2054:Hyperchloremic
2046:
2045:
2044:
2039:
2034:
2029:
2022:High anion gap
2018:
2016:
2007:
2001:
2000:
1995:
1993:
1992:
1985:
1978:
1970:
1961:
1960:
1957:
1956:
1954:article/768159
1945:
1933:
1932:
1930:
1926:
1925:
1922:
1921:
1910:
1899:
1884:
1869:
1853:
1848:
1847:
1845:
1844:Classification
1837:
1836:External links
1834:
1831:
1830:
1819:(2): 103–114.
1803:
1762:
1727:
1688:
1644:
1632:
1618:
1604:
1586:
1557:(3): 731–737.
1532:
1514:
1488:
1461:(11): 1123–7.
1445:
1396:
1347:
1304:
1298:978-1455750177
1297:
1279:
1260:(4): 339–347.
1244:
1215:(3): 278–285.
1195:
1153:
1135:
1111:
1074:(5): 295–300.
1054:
1013:
972:
923:
896:(7): 833–843.
880:
837:
820:
762:
755:
736:
735:
733:
730:
706:S. ruminantium
675:
672:
638:
635:
633:
630:
622:
619:
607:ketogenic diet
589:hemofiltration
569:
566:
559:
558:
555:
552:
551:Arterial blood
548:
547:
544:
541:
537:
536:
533:
530:
513:
510:
488:production by
448:
445:
444:
443:
442:
441:
435:
430:
425:
412:
405:bowel ischemia
401:
394:
389:
384:
379:
374:
369:
364:
359:
356:
343:
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336:
326:
321:
316:
308:
302:
297:
292:
286:
272:
267:
259:
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257:
255:Leigh syndrome
252:
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237:
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227:
222:
217:
196:
193:
168:
165:
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163:
162:
161:
155:
152:
146:
130:
129:Classification
127:
111:hemofiltration
74:
73:
60:
54:
53:
47:
46:
38:
37:
29:
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
2167:
2156:
2153:
2152:
2150:
2135:
2132:
2130:
2127:
2126:
2124:
2120:
2114:
2111:
2107:
2104:
2103:
2102:
2099:
2098:
2096:
2094:
2090:
2080:
2077:
2076:
2074:
2072:
2068:
2060:
2059:Renal tubular
2057:
2055:
2052:
2051:
2050:
2047:
2043:
2040:
2038:
2035:
2033:
2030:
2028:
2025:
2024:
2023:
2020:
2019:
2017:
2015:
2011:
2008:
2006:
2002:
1998:
1991:
1986:
1984:
1979:
1977:
1972:
1971:
1968:
1955:
1951:
1950:
1946:
1944:
1940:
1939:
1935:
1934:
1931:
1927:
1920:
1916:
1915:
1911:
1909:
1905:
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1900:
1898:
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1885:
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1879:
1878:
1874:
1870:
1868:
1864:
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1859:
1855:
1854:
1851:
1846:
1842:
1835:
1826:
1822:
1818:
1814:
1807:
1804:
1799:
1795:
1790:
1785:
1782:(2): 418–26.
1781:
1777:
1773:
1766:
1763:
1758:
1754:
1750:
1746:
1743:(1): 206–16.
1742:
1738:
1731:
1728:
1723:
1719:
1715:
1711:
1708:(1): 275–86.
1707:
1703:
1699:
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1689:
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1670:
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1662:
1658:
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1366:
1362:
1358:
1351:
1348:
1343:
1339:
1335:
1331:
1327:
1323:
1320:(4): 379–83.
1319:
1315:
1308:
1305:
1300:
1294:
1290:
1283:
1280:
1275:
1271:
1267:
1263:
1259:
1255:
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1228:
1223:
1218:
1214:
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1199:
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1187:
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1173:
1169:
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1149:
1145:
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1136:
1125:
1121:
1115:
1112:
1107:
1103:
1098:
1093:
1089:
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1077:
1073:
1069:
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1041:
1036:
1032:
1028:
1027:Diabetes Care
1024:
1017:
1014:
1009:
1005:
1000:
995:
991:
987:
983:
976:
973:
968:
964:
959:
954:
950:
946:
942:
938:
934:
927:
924:
919:
915:
911:
907:
903:
899:
895:
891:
884:
881:
876:
872:
868:
864:
860:
856:
853:(3): 257–65.
852:
848:
841:
838:
835:
831:
830:
824:
821:
816:
812:
808:
804:
800:
796:
789:
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756:0-632-09460-5
752:
748:
741:
738:
731:
729:
725:
721:
719:
713:
711:
707:
703:
699:
698:Lactobacillus
695:
694:
689:
683:
681:
673:
671:
669:
665:
661:
657:
654:
649:
647:
643:
636:
632:Other animals
631:
629:
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618:
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612:
608:
603:
601:
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585:
583:
579:
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565:
556:
553:
550:
549:
545:
542:
539:
538:
534:
531:
529:
528:
525:
523:
520:. Testing of
519:
511:
509:
507:
503:
497:
493:
491:
487:
483:
479:
475:
471:
467:
463:
458:
454:
446:
440:
436:
434:
431:
429:
426:
424:
420:
419:Non-Hodgkin's
416:
413:
410:
406:
402:
399:
395:
393:
390:
388:
385:
383:
380:
378:
375:
373:
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200:
194:
192:
190:
186:
182:
178:
174:
166:
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156:
153:
150:
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147:
144:
143:
142:
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136:
128:
126:
124:
120:
116:
112:
108:
103:
101:
97:
93:
89:
85:
80:
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64:
63:Endocrinology
61:
59:
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48:
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39:
34:
19:
2041:
2027:Ketoacidosis
1947:
1936:
1912:
1901:
1886:
1871:
1856:
1816:
1812:
1806:
1779:
1775:
1765:
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1730:
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1691:
1664:
1661:J. Dairy Sci
1660:
1554:
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1517:
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1458:
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1413:
1409:
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1360:
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1288:
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1257:
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1208:
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1171:
1167:
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1127:. Retrieved
1123:
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1067:
1057:
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1030:
1026:
1016:
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985:
975:
940:
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926:
893:
889:
883:
850:
846:
840:
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798:
794:
746:
740:
726:
722:
714:
705:
701:
697:
691:
687:
684:
677:
650:
640:
627:
624:
604:
593:
586:
574:vasopressors
571:
562:
540:Venous blood
522:venous blood
515:
498:
494:
450:
398:overtraining
367:Polymyositis
198:
183:, or severe
170:
132:
104:
81:
77:
2113:Respiratory
2079:Respiratory
2071:Respiratory
1938:MedlinePlus
992:(2): 20–9.
943:(1): 20–8.
702:M. elsdenii
578:some agents
339:Fialuridine
300:Epinephrine
36:Lactic acid
1914:DiseasesDB
1129:2016-03-25
732:References
646:glycolysis
484:to enable
478:acetyl-CoA
474:Cori cycle
453:glycolysis
409:cellulitis
407:or marked
311:Nucleoside
283:phenformin
2101:Metabolic
2093:Alkalosis
2014:Metabolic
1949:eMedicine
1231:0103-507X
1148:Drugs.com
1088:2234-7550
674:Ruminants
656:hibernate
621:Prognosis
602:levels).
568:Treatment
512:Diagnosis
289:Isoniazid
275:Metformin
265:Linezolid
58:Specialty
2149:Category
2005:Acidosis
1581:12231634
1524:Archived
1483:24262456
1475:25079826
1440:22513923
1391:18647626
1342:22613993
1334:18614899
1274:24703052
1239:25307096
1106:27847739
1049:16567854
1008:26773926
967:21143497
918:23123288
910:28538105
875:45323262
867:23772060
815:25494270
680:ruminant
642:Reptiles
637:Reptiles
557:0.5–1.6
554:4.5–14.4
546:0.5–2.2
543:4.5–19.8
466:pyruvate
457:pyruvate
417:such as
362:Bleeding
295:Propofol
291:toxicity
96:vomiting
1908:D000140
1798:7275867
1757:7319937
1722:9464909
1683:9178142
1572:2290531
1431:7201312
1382:3746325
1190:7565947
1097:5104873
958:3018022
600:calcium
415:Cancers
148:Type B
88:chronic
2042:Lactic
1943:000391
1867:5C73.Y
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1755:
1720:
1681:
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1569:
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1124:RxList
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955:
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873:
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753:
664:anoxic
506:asthma
377:Sepsis
345:Other
261:Drugs
215:biotin
195:Causes
175:, the
173:sepsis
92:nausea
65:
2122:Other
1919:29145
1897:276.2
1882:E87.2
1505:(PDF)
1479:S2CID
1338:S2CID
914:S2CID
871:S2CID
532:mg/dL
382:Shock
139:Woods
135:Cohen
84:acute
1903:MeSH
1892:9-CM
1794:PMID
1753:PMID
1718:PMID
1679:PMID
1577:PMID
1471:PMID
1436:PMID
1387:PMID
1330:PMID
1293:ISBN
1270:PMID
1235:PMID
1227:ISSN
1186:PMID
1102:PMID
1084:ISSN
1045:PMID
1004:PMID
963:PMID
906:PMID
863:PMID
811:PMID
751:ISBN
704:and
421:and
157:B3:
133:The
1888:ICD
1873:ICD
1858:ICD
1821:doi
1784:doi
1745:doi
1710:doi
1669:doi
1567:PMC
1559:doi
1555:543
1463:doi
1426:PMC
1418:doi
1377:PMC
1369:doi
1322:doi
1262:doi
1217:doi
1176:doi
1172:333
1092:PMC
1076:doi
1035:doi
994:doi
953:PMC
945:doi
898:doi
855:doi
803:doi
799:371
710:pKa
678:In
535:mM
486:ATP
353:TPN
86:or
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1862:11
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Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
