{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:58:28Z","timestamp":1760029108806},"reference-count":15,"publisher":"California Digital Library (CDL)","issue":"5","license":[{"start":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T00:00:00Z","timestamp":1617840000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: The term \u201clactic acidosis\u201d reinforces the misconception that lactate contributes to acidemia. Although it is common to discover an anion gap acidosis with a concomitant elevated lactate concentration, the two are not mutually dependent.\n\nCase Report: Here we describe two patients exhibiting high lactate concentrations in the setting of metabolic alkalemia. \n\nConclusion: Lactate is not necessarily the direct cause of acid-base disturbances, and there is no fixed relationship between lactate and the anion gap or between lactate and pH. The term \u201cmetabolic acidosis with hyperlactatemia\u201d is more specific than \u201clactic acidosis\u201d and thus more appropriate.<\/jats:p>","DOI":"10.5811\/cpcem.2021.2.51634","type":"journal-article","created":{"date-parts":[[2021,5,21]],"date-time":"2021-05-21T01:14:30Z","timestamp":1621559670000},"page":"182-185","source":"Crossref","is-referenced-by-count":0,"title":["A Report of Two Cases: Unlearning Lactic Acidosis"],"prefix":"10.5811","volume":"2","author":[{"given":"Sanjay","family":"Mohan","sequence":"first","affiliation":[{"name":"NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Goldfarb","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine, Division of Nephrology, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Hoffman","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2021,4,8]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Berend K, de Vries AP, Gans RO. Physiological approach to assessment of acid-base disturbances. N Engl J Med. 2014;371(15):1434-45. 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Lactate as a hemodynamic marker in the critically ill.\u00a0Curr Opin Crit Care. 2012;18(3):267-72.","DOI":"10.1097\/MCC.0b013e3283532b8a"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Kraut JA and Madias NE. Lactic acidosis. N Engl J Med. 2014;371(24):2309-19.","DOI":"10.1056\/NEJMra1309483"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Emmett M and Narins RG. Clinical use of the anion gap. Medicine (Baltimore). 1977;56(1):38-54.","DOI":"10.1097\/00005792-197756010-00002"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Iberti TJ, Leibowitz AB, Papadakos PJ, et al. Low sensitivity of the anion gap as a screen to detect hyperlactatemia in critically ill patients. Crit Care Med. 1990;18(3):275-7.","DOI":"10.1097\/00000542-198909001-00171"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Huckabee WE. Relationships of pyruvate and lactate during anaerobic metabolism. I. Effects of infusion of pyruvate or glucose and of hyperventilation. J Clin Invest. 1958;37(2):244-54.","DOI":"10.1172\/jci103603"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Relman AS. Metabolic consequences of acid-base disorders. Kidney Int. 1972;1(5):347-59.","DOI":"10.1038\/ki.1972.46"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Madias NE. Lactic acidosis. Kidney Int. 1986;29(3):752-74.","DOI":"10.1038\/ki.1986.62"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Bersin RM and Arieff AI. Primary lactic alkalosis. Am J Med. 1988;85(6):867-71.","DOI":"10.1016\/S0002-9343(88)80039-1"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Kilburn KH. Shock, seizures, and coma with alkalosis during mechanical ventilation. Ann Intern Med. 1966;65(5):977-84.","DOI":"10.7326\/0003-4819-65-5-977"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Reynolds HN, Teiken P, Regan ME, et al. Hyperlactatemia, increased osmolar gap, and renal dysfunction during continuous lorazepam infusion. Crit Care Med. 2000;28(5):1631-4.","DOI":"10.1097\/00003246-200005000-00063"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Van de Wiele B, Rubinstein E, Peacock W, et al. Propylene glycol toxicity caused by prolonged infusion of etomidate. J Neurosurg Anesthesiol. 1995;7(4):259-62.","DOI":"10.1097\/00008506-199510000-00004"}],"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2021,5,21]],"date-time":"2021-05-21T01:14:37Z","timestamp":1621559677000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/64h7s607"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,8]]},"references-count":15,"issue-title":["Clinical Practice and Cases in Emergency Medicine"],"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,18]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.2021.2.51634","relation":{},"ISSN":["2474-252X","2474-252X"],"issn-type":[{"type":"electronic","value":"2474-252X"},{"type":"print","value":"2474-252X"}],"subject":[],"published":{"date-parts":[[2021,4,8]]}}}