Abstract:

Background: Malaria is of immense importance among tropical diseases in India. Pathophysiology of complicated malaria is multifactorial in origin involving tissue hypoxia, liver dysfunction, and impaired renal handling of bicarbonate. Acidosis is an important contributor to death from severe falciparum malaria. Metabolic acidosis results from abnormal microcirculatory perfusion and anaerobic glycolysis as a result of sequestration of parasitized erythrocytes and, also, cellular dysfunction consequent on release of host and parasite-derived toxic mediators.

Material and methods: The study was conducted at Victoria and Bowring & lady Curzon hospitals, attached to Bangalore medical college & research institute, Bangalore. A total of 40 patients with complicated malaria with respect to serum lactate levels measured serially every 24hours were studied.

Results: During our study, 24 out of 40 patients had lactate levels >19.8mg/dl. Out of these 24 patients,10 were given blood transfusion,3 were given platelet transfusion,9 were given inotropic support and 2 were dialysed as compared to patients with normal lactate levels who were 4,1,2 and 0 respectively; implying the fact that the incidence of complications are high in patients with hyperlactatemia. Also, 3 patients died during the study; all of them were from increasing levels of lactate levels on day 3 when compared to levels at the time of admission.

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