A 52-year-old woman on ICU develops lactic acidosis (lactate 8.5 mmol/L) with haemodynamic stability (MAP 75 mmHg, CI 3.5 L/min/m2). She is receiving ...

Question

A 52-year-old woman on ICU develops lactic acidosis (lactate 8.5 mmol/L) with haemodynamic stability (MAP 75 mmHg, CI 3.5 L/min/m2). She is receiving IV adrenaline 0.1 mcg/kg/min for bronchospasm. No other signs of sepsis or hypoperfusion are present. What is the most likely explanation?

Accepted Answer

Adrenaline-induced type B (aerobic) lactic acidosis from stimulation of glycolysis via beta-2 adrenergic receptor activation

Answer

Occult sepsis requiring broader antibiotics

Answer

Tissue hypoperfusion from inadequate cardiac output

Answer

Mesenteric ischaemia

Answer

Metformin toxicity

uk-fficm MCQ (SBA): Type B Lactic Acidosis

A 52-year-old woman on ICU develops lactic acidosis (lactate 8.5 mmol/L) with haemodynamic stability (MAP 75 mmHg, CI 3.5 L/min/m2). She is receiving IV adrenaline 0.1 mcg/kg/min for bronchospasm. No other signs of sepsis or hypoperfusion are present. What is the most likely explanation?