A Controlled Clinical Trial of Dichloroacetate for Treatment of Lactic Acidosis in Adults

LACTIC acidosis is a common disorder of acid–base metabolism that occurs in patients with many life-threatening illnesses. The mortality rate among patients with lactic acidosis is high, 1 2 3 but whether lactic acidosis influences the prognosis independently of the underlying disease and, if so, whether specific treatment and amelioration of lactic acidosis improve survival are not known. Several uncontrolled studies have suggested that treatment with dichloroacetate may reduce not only morbidity but also mortality in patients with lactic acidosis caused by hypotension or sepsis. 4 5 6 Dichloroacetate ameliorates lactic acidosis by increasing myocardial glucose oxidation and contractility and by inhibiting glycolysis, thereby decreasing lactate . . .