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What is lactic acidosis?
A lactic acidosis is a form of metabolic acidosis that begins when a person overproduces lactic acid or its metabolite products are underutilized, and their bodies are unable to adapt to these changes. People with lactic acidosis have problems with the function of their liver (and sometimes their kidneys) being able to excrete excess acid from the body. If lactic acid builds up in the body faster than it can be eliminated, the acidity level in body fluids such as blood will soar.

This buildup of acids causes an imbalance in the pH level of the body, which should always be alkaline, not acidic. Lactic acid buildup occurs when there is not enough oxygen in the muscles to break down glucose and glycogen. This is called anaerobic metabolism.
There are two types of lactic acid: L-lactic and D-lactic. Most forms of lactic acidosis are caused by too much L-lactate. There are two types of lactic acidosis:
     1. Type A lactic acidosis is caused by tissue hypoperfusion (lack of nutrition) from heart failure, sepsis, or cardiac pulmonary arrest.
     2. Type B lactic acidosis is caused by impaired cellular level function and local area tissue hypoperfusion. Lactic acidosis has many causes and

         is often treatable. But if left untreated, it may be life-threatening.

What are the symptoms of lactic acidosis?
The symptoms of lactic acidosis are typical of many health problems. If you experience any of these symptoms you should contact your doctor immediately. Your doctor can help determine the root cause. Some of the common symptoms of lactic acidosis are medical emergencies, fruity breath (a possible indication of a serious complication of diabetes, called ketoacidosis), confusion, jaundice (yellowing of the skin or whites of the eyes), difficulty breathing, rapid breathing.

If you know or suspect that you have lactic acidosis and these symptoms, go to the emergency room immediately. Other symptoms of lactic acidosis include fever or extremes, muscle cramps or pain, weakness, an overall feeling of physical discomfort, abdominal pain or discomfort, diarrhea, decreased appetite, and headache

What causes lactic acidosis?

Lactic acidosis has many underlying causes, including carbon monoxide poisoning, cholera, malaria, and shortness of breath. Some of the common causes include:

  • Heart disease
    Conditions such as heart arteries and congestive heart failure can reduce blood and oxygen flow throughout the body. This can increase lactic acid levels.
  • Severe infection (sepsis)
    Any kind of severe viral or bacterial infection can cause sepsis. People with sepsis may experience a lactic acid surge, which is caused by reduced oxygen flow.
  • HIV
    HIV drugs, such as Nucleoside Reverse Transcriptase Inhibitors (NRTIs), can increase lactic acid. They can also cause liver damage. This makes it more difficult for the body to process lactate.
  • Cancer
    Cancer cells produce lactic acid. This lactic acid buildup can increase with weight loss and disease progression.
  • Short bowel syndrome 
    Although it's rare, people with a short intestine may experience a build-up of D-lactic acid, which is caused by an overgrowth of bacteria in the small intestine. People who have had gastric bypass surgery also may experience D-lactic acidosis.
  • Use of acetaminophen class drugs
    Continuous use of acetaminophen (Paracetamol) can cause lactic acidosis, even when taken at the correct dosage. This is because it can cause pyroglutamic acid to build up in the blood.
  • Chronic alcoholism
    Drinking alcohol in excess for a long period of time can lead to lactic acidosis and alcoholic ketoacidosis. Alcoholic ketoacidosis is a condition that is not fatal if it is not served but can be resolved by intravenous (IV) hydration and glucose. Alcohol increases phosphate levels, which negatively affects the kidneys. This makes the body's pH more acidic. Exercise or intense physical activity. The temporary buildup of lactic acid can be caused by strenuous exercise if your body doesn't have enough oxygen to break down glucose in the blood. This can cause burning in the muscle groups you use. It can also cause nausea and weakness.

The relation between lactic acidosis and diabetes
Special classes of oral diabetes medications, such as biguanides, can cause a buildup of lactic acid levels. Metformin is one of these drugs. Metformin is used to treat diabetes and may also be prescribed for other conditions, such as impaired kidney function. Metformin is also used off-label to treat Polycystic Ovary Syndrome (PCOS). In diabetics, lactic acidosis may be of more concern if kidney disease is present as well.

How to diagnosed lactic acidosis?
Lactic acidosis is diagnosed through a blood test. Your doctor may instruct you to fast (including drinking) for 8 to 10 hours before taking the test. You may also be instructed to limit your activity levels in the hours leading up to the exam. During the test, your doctor may tell you not to clench your fists, as this can artificially raise acid levels. Tying an elastic band around the arm can also cause this. For this reason, a lactic acidosis blood test is sometimes done by finding the blood vessels on the back of the hand, not the arm.

What are the treatment options for lactic acidosis?

The best way to treat lactic acidosis is by treating the root cause. Therefore, the treatment varies. Lactic acidosis is sometimes a medical emergency. This requires treatment, regardless of the root cause. Increasing oxygen to tissues and offering intravenous fluids are often used to lower lactic acid levels.

The lactic acidosis caused by medication can be treated at home. Stopping what you're doing to hydrate and rest, helps help. Sports drinks, such as electrolyte drinks, aid hydration, but still, water is usually best.

What is the prognosis of the disease in the future?
Based on the root cause, treatment for lactic acidosis often provides full recovery, especially if treatment is prompted. Sometimes, kidney failure or respiratory failure can occur. Left untreated, lactic acidosis can be fatal.

How to prevent lactic acidosis?

Prevention of lactic acidosis is also determined by its potential causes. If you have diabetes, HIV, or cancer, discuss your condition and any medications you have with your doctor. Lactic acidosis from exercise can be prevented by staying hydrated and giving yourself long breaks in exercise sessions.

What is the practical measurement of lactate levels in the blood?

  1. Measurement of lactic acid levels as part of the monitoring of cases of lactic acidosis can be easily carried out independently and practically with a reliable POCT (Point of Care Test) tool in examining the lactic acid profile in the blood THE EDGE ™ Blood Lactate Monitoring System. THE EDGE ™ Blood Lactate Monitoring System can be used by people with diabetes mellitus and its complications, asthma, sepsis, and chronic obstructive pulmonary disease. However, it can also be used by healthy people who wish to monitor their lactic acid profile after exercise. So THE EDGE ™ Blood Lactate Monitoring System is also suitable for use by athletes and coaches to accurately assess the muscle ability for the performance of a professional athlete to improve performance according to the expected target. The following are the features and advantages of THE EDGE ™ Blood Lactate Monitoring System.
  2. The measuring range is wide, namely 6 ~ 200 mg / dL (0.7 ~ 22.2 mmol / L)
    With a wide measuring range, THE EDGE ™ Blood Lactate Monitoring System will greatly facilitate monitoring of the lactic acid profile in blood in both low and high conditions.
  3. Measuring time 45 seconds
    THE EDGE ™ Blood Lactate Monitoring System can take a reading of the lactic acid profile in the blood in a very short time so that the determination of the next action can be determined in a time-efficient manner.
  4. Sample volume 3µL whole blood
    With a very small number of samples and using whole blood cells (whole blood), THE EDGE ™ Blood Lactate Monitoring System can show the profile of lactic acid in blood accurately, thus minimizing the risk of excessive pain in collecting blood test samples.

With the information on the features and advantages above, it is hoped that it will make it easier for us to determine the measuring instrument for lactate levels in the blood with THE EDGE ™ Blood Lactate Monitoring System.



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  7. Insert Page THE EDGE™ Blood Lactate Monitoring System by Apexbio.
  8. Lipska KJ, dkk. (2011). Penggunaan metformin dalam pengaturan insufisiensi ginjal ringan sampai sedang. 
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  11. Puwanant M, dkk. (2005). Asidosis D-laktat berulang pada anak dengan sindrom usus pendek.
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