Pneumonia and the body's response p8

Lactate is a byproduct of glycolosis, which is an anaerobic glucose metabolism occurring in the cellular cytoplasm.  Pyruvate is also generated through glycolosis and is broken down through the Krebs cycle to create energy (Sharma 2007).  The liver’s lactate to glucose conversion ability decreases when there are elevated blood levels of lactose (Sharma 2007).   Once the liver can no longer maintain the lactate to glucose conversion, acidosis begins. With adequate oxygen, adenosine triphosphate (ATP) metabolites are recycled and cytosolic lactate concentration increases without acidosis (Sharma 2007).  Hypoxia prompts cells to utilize anaerobic energy to create ATP resulting in lactate and hydrogen (Sharma 2007).  Sepsis accounts for most cases of lactic acidosis (Sharma 2007).

Arterial blood gasses need to be drawn in order to identify the current condition of our patient as well as a full assessment.  Continued monitoring would be warranted during critical states of illness.  Signs of impaired tissue perfusion consist of hypotension, peripheral vasoconstriction, and oliguria (Sharma 2007).  Signs of septic shock include tachypnia, hypotension, and decreased mental status (Sharma 2007). The appropriate treatment for this patient is to treat the underlying cause of the acidosis, in other words, treat the pneumonia.  In the case of lactic acidosis, sodium bicarbonate may be given to balance the pH.  ABG and patient monitoring are necessary to ensure appropriate treatment is being administered.