{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:00:04Z","timestamp":1793232004401,"version":"4.5.0"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Lactic acidosis in the emergency department and other hospital settings is typically due to tissue hypoxia with sepsis being the most common cause. However, in patients with persistently elevated lactate without evidence of inadequate oxygen delivery, type B lactic acidosis should be considered. We report the case of a 12-year-old boy with relapsed and refractory pre\u2013B-cell acute lymphoblastic leukemia who presented in distress with tachycardia, history of fever, and diffuse abdominal tenderness. The patient had severe metabolic acidosis with elevated lactate upon arrival to the emergency department. Despite aggressive fluid resuscitation and intravenous antibiotics, the patient's acidosis worsened. Serial blood cultures were negative, and he was eventually diagnosed with type B lactic acidosis secondary to relapsed acute lymphoblastic leukemia.<\/jats:p>","DOI":"10.1097\/pec.0000000000001603","type":"journal-article","created":{"date-parts":[[2018,8,31]],"date-time":"2018-08-31T18:49:39Z","timestamp":1535741379000},"page":"e165-e167","source":"Crossref","is-referenced-by-count":14,"title":["Lactic Acidosis in a Critically Ill Patient"],"prefix":"10.1097","volume":"34","author":[{"given":"Abigail M.","family":"Schuh","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasey Joanne","family":"Leger","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology-Oncology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Summers","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology-Oncology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil G.","family":"Uspal","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"bib1-20230930","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.ccc.2009.12.007","article-title":"Lactic acidosis: recognition, kinetics, and associated prognosis","volume":"26","year":"2010","journal-title":"Crit Care Clin"},{"key":"bib2-20230930","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1097\/CCM.0000000000000742","article-title":"Lactate measurements in sepsis-induced tissue hypoperfusion: results from the Surviving Sepsis Campaign database","volume":"43","year":"2015","journal-title":"Crit Care Med"},{"key":"bib3-20230930","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/j.mayocp.2013.06.012","article-title":"Etiology and therapeutic approach to elevated lactate","volume":"88","year":"2013","journal-title":"Mayo Clin Proc"},{"key":"bib4-20230930","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1542\/peds.2014-2289","article-title":"Type B lactic acidosis secondary to thiamine deficiency in a child with malignancy","volume":"135","year":"2015","journal-title":"Pediatrics"},{"key":"bib5-20230930","first-page":"580","article-title":"Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012","volume":"41","year":"2012","journal-title":"Crit Care Med"},{"key":"bib6-20230930","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/1471-2431-14-83","article-title":"Effectiveness of predicting in-hospital mortality in critically ill children by assessing blood lactate levels at admission","volume":"14","year":"2014","journal-title":"BMC Pediatr"},{"key":"bib7-20230930","first-page":"225","article-title":"Type B lactic acidosis as a severe metabolic complication in lymphoma and leukemia: a case series from a single institution and literature review","volume":"886","year":"2007","journal-title":"Medicine (Baltimore)"},{"key":"bib8-20230930","first-page":"61","article-title":"A rare metabolic complication of acute lymphoblastic leukemia in childhood; 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