PT - JOURNAL ARTICLE AU - Jerome F. O’Hara, JR AU - John E. Tetzlaff AU - Michael P. Smith TI - Severe perioperative lactic acidosis: How clinically significant is it? DP - 1994 Jul 01 TA - Cleveland Clinic Journal of Medicine PG - 314--316 VI - 61 IP - 4 4099 - http://www.ccjm.org/content/61/4/314.short 4100 - http://www.ccjm.org/content/61/4/314.full SO - Cleve Clin J Med1994 Jul 01; 61 AB - BACKGROUND Lactic acidosis, generally defined as a plasma lactate concentration in excess of 5 mmol/L with a concomitant blood pH less than 7.25, is reported to have a direct association with mortality.OBJECTIVE To report a case of unexplained perioperative lactic acidosis and to discuss the etiology, recognition, treatment, and importance of a transient rise in plasma lactate concentration.SUMMARY Severe lactic acidosis developed in a 40-year-old man with Crohn's disease during major abdominal surgery. The plasma lactate concentration reached 16.9 mmol/L (normal range1.5 to 2.2 mmol/L). This condition resolved within 14 hours without harm to the patient.CONCLUSIONS When lactate accumulates in the perioperative period, the responsible condition is most often self-limiting. Reversible, subacute, marked lactic acidosis should not be assumed to predict mortality as it does in patients whose plasma lactate concentrations remain chronically elevated during severe systemic diseases such as sepsis.