increasing the lactatetopyruvate ratio. States of enhanced metabolic activity (e.g., grand mal seizures, strenuous
exercise, or hyperthermia), decreased tissue oxygen delivery (e.g., severe anemia, hypoxia, circulatory shock,
or carbon monoxide poisoning), or impaired oxygen utilization (e.g., cyanide toxicity) all are associated with
lactic acidosis. Impaired hepatic clearance of lactate, as seen in hypoperfusion states, liver failure, and alcohol
intoxication, can also result in lactic acidosis.