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dc.contributor.authorUlvin, Ole Erik
dc.contributor.authorNielsen, Erik Waage
dc.date.accessioned2015-10-06T11:00:01Z
dc.date.available2015-10-06T11:00:01Z
dc.date.issued2013-10-20
dc.description.abstractCase report A 49-year-old previously healthy man was admitted to the ICU after cardiac arrest following a short history with headache, blurred speech and reduced consciousness. After cardiopulmonary resuscitation perfusion rhythm was regained, but the patient didn`t regain consciousness. The arterial blood gas analysis at the ICU revealed a severe metabolic acidosis with pH at 6.86 and lactate levels of 16 mmol/L. The white blood cells count was also markedly increased (312 * 109 /L), and blood smear showed immature cells indicating acute leukemia. The severe metabolic acidosis, at first thought to be due to systemic hypoperfusion, did not improve in spite of fluid and vasopressor resuscitation. A CT scan of the head performed the next day, revealed massive cerebellar haemorrhage, edema in both hemispheres and signs of anoxic brain damage. Immunophenotyping of peripheral blood was consistent with Acute Myeloid Leukemia (AML). Discussion Lactic acidosis is a common cause of metabolic acidosis at the ICU. Type A is most common and caused by hypoperfusion or hypoxia, whilst type B has other causes including use of the antidiabetic drug metformin and hematological malignancies. The latter should be considered when presented to persistent lactic acidosis after adequate systemic perfusion has been reestablished.en_US
dc.identifier.citationJournal of Medical Case Reports 1(2013) nr. 2 s. -en_US
dc.identifier.cristinIDFRIDAID 1088494
dc.identifier.doi10.15744/2348-9820.1.202
dc.identifier.issn1752-1947
dc.identifier.urihttps://hdl.handle.net/10037/8193
dc.identifier.urnURN:NBN:no-uit_munin_7775
dc.language.isoengen_US
dc.publisherBioMed Central Ltd.en_US
dc.rights.accessRightsopenAccess
dc.subjectlactic acidosisen_US
dc.subjectemergency medicineen_US
dc.subjectICUen_US
dc.subjectmetabolic acidosisen_US
dc.subjectsystemic hypoperfusionen_US
dc.subjecthypoxiaen_US
dc.subjectcardiac arresten_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750en_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750en_US
dc.titleUnexplained severe lactic acidosis in emergency medicineen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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