This keeps the sugar from carmelizing. When you give someone LR or lactate, do you get lactic acidosis-D?
Well lactate is a base and not the acid so it should not and hence we don't see it causing it. LR is a widely used fluid and lactate in PD fluid is also widely used. Accumulation of D lactic acid will cause an anion gap if that would happen. The lactate( base ) is not usually associated with this problem.
Where do you see D lactic acidosis? It can occur in patients with jejunoileal bypass or, less commonly, small bowel resection or other cause of the short bowel syndrome. This is due to overgrowth of gram positive anerobes and relatively low glucose delivery to the colon.
Think of this diagnosis when there is elevated anion gap, normal lactate, negative ketones, considered in the patient presenting with an increased serum anion gap, normal serum concentrations of lactate, negative ketones, and history of short gut syndrome or bypass as stated above.
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