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Acidosis láctica

Definición

Se refiere al ácido láctico que se acumula en el torrente sanguíneo. El ácido láctico se produce cuando los niveles de oxígeno disminuyen en las células dentro de las áreas del cuerpo en las que se lleva a cabo el metabolismo o en respuesta a la hiperactividad simpática relacionada con las sustancias de tipo epinefrina o el ejercicio.

Causas

La causa más común de la acidosis láctica es una enfermedad grave en la cual la presión arterial es baja y llega muy poco oxígeno a los tejidos del cuerpo. El ejercicio intenso o las convulsiones pueden cuausar acidosis láctica temporalmente. Algunas enfermedades también pueden causar esta afección, incluyendo:

Sida
Alcoholismo
Cáncer
Cirrosis
Envenenamiento por cianuro
Insuficiencia renal
Insuficiencia respiratoria
Sepsis (infección grave)

Pocas veces, algunos medicamentos pueden causar acidosis láctica:

Inhaladores agonistas beta adrenérgicos utilizados para tratar el asma o la EPOC (albuterol y salbutamol)
La epinefrina
Linezolid
La metformina, utilizada para tratar la diabetes (a menudo con una dosis excesiva)
Inhibidores nucleósidos de la transcriptasa inversa utilizados para tratar la infección por VIH
Propofol

Síntomas

Los síntomas pueden incluir:

Náuseas
Vómito
Debilidad

Pruebas y exámenes

Las pruebas pueden incluir un examen de sangre para verificar los niveles de lactato y electrolitos.

Tratamiento

El tratamiento principal para la acidosis láctica es corregir el problema de salud que causa esta afección.

Referencias

McCoin NS, Self WH. Acid-base disorders. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 113.

Palmer BF. Metabolic acidosis. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 12.

Seifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 110.

Programe una cita

Actualizado : 10/25/2022

Versión en inglés revisada por : Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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