An elevated lactic acid level can be caused by several entities including select medications, intense exercise, recent seizures, decreased clearance by the liver, and any clinical state marked by hypoperfusion or a low flow state. Examples include low blood pressure, low oxygen levels, or low blood flow related to ischemia. An elevated lactic acid level is also concerning for sepsis, severe sepsis, or septic shock. A lactic acid level greater than 4 with clinical concern for sepsis triggers the need for early goal-directed therapy for sepsis. With severe abdominal pain, tenderness on exam, and CT scan findings of possible enterocolitis, an elevated lactic acid level raises even more concern for acute mesenteric ischemia.
Elevated lactic acid level medical expert witness specialties include internal medicine and infectious diseases.