Document Detail


Type A lactic acidosis in occupational heat exhaustion.
MedLine Citation:
PMID:  12637600     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This paper presents a further analysis of biochemical data collected during a 1 year prospective study of 106 cases of heat exhaustion at a deep underground metalliferous mine. RESULTS: Multiple regression analysis results indicate that the haemoglobin, serum creatinine and plasma lactate concentrations are statistically significant predictors of the anion gap. Together, they explain 65% of the variance in the anion gap (R(2) = 0.650). Spearman's rho correlation results also confirm that haemoglobin, creatinine and lactate are each statistically significantly correlated with the anion gap (P < 0.001). CONCLUSIONS: These results indicate that dehydration and lactate are important determinants of the metabolic acidosis previously observed in occupational heat exhaustion. It is likely that dehydration in these workers has resulted in poor muscle perfusion, anaerobic conditions and elevated lactate. This constitutes Type A lactic acidosis. Creatine kinase is not a statistically significant predictor of the anion gap in multiple regression (P = 0.956). Furthermore, the Spearman's rho correlation coefficient for creatine kinase versus the anion gap is weak (r(s) = 0.175) and is not statistically significant (P = 0.073). These results suggest that there was no rhabdomyolysis contributing to the metabolic acidosis.
Authors:
A M Donoghue
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Occupational medicine (Oxford, England)     Volume:  53     ISSN:  0962-7480     ISO Abbreviation:  Occup Med (Lond)     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-14     Completed Date:  2003-05-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9205857     Medline TA:  Occup Med (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  139-42     Citation Subset:  IM    
Affiliation:
The School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, QLD 4059, Australia. amdonoghhue@bigpond.com
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MeSH Terms
Descriptor/Qualifier:
Acid-Base Equilibrium
Acidosis, Lactic / blood,  complications*
Creatine Kinase / blood
Creatinine / blood
Heat Exhaustion / complications*
Hemoglobins / analysis
Humans
Lactates / blood
Metallurgy
Mining*
Occupational Diseases / blood,  complications*
Prospective Studies
Regression Analysis
Chemical
Reg. No./Substance:
0/Hemoglobins; 0/Lactates; 60-27-5/Creatinine; EC 2.7.3.2/Creatine Kinase

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