UMEM Educational Pearls

Category: Critical Care

Title: Type B Lactic Acidosis

Posted: 4/13/2010 by Mike Winters, MD (Updated: 4/1/2023)
Click here to contact Mike Winters, MD

Type B Lactic Acidosis

  • In the critically ill, patients may often have elevated lactate levels without ongoing tissue hypoperfusion.
  • In these patients it is important to consider the causes of what is referred to as "Type B Lactic Acidosis".
  • Pertinent to critically ill ED patients, consider the following:
    • Type B1 - related to underlying disease
      • renal faiilure
      • hepatic failure
      • malignancy
      • HIV
    • Type B2 - effects of drugs/toxins
      • acetaminophen
      • alcohols
      • beta-adrenergic agents: epinephrine
      • cocaine, methamphetamine
      • propofol
      • salicylates
      • valproic acid
      • metformin
    • Type B3 - inborn errors of metabolism


Vernon C, LeTourneau JL. Lactic acidosis: Recognition, kinetics, and associated prognosis. Crit Care Clin 2010; 26:255-83.