Excerpt :
Acidosis is a complex metabolic state with a range of etiologies (Planche and Krishna 2006; Taylor et al. 2012). Within malaria, acidosis is caused by a combination of several factors. The malaria parasite produces Plasmodiumlactate dehydrogenase (pLDH), which creates lactic acid leading to decreased pH. Respiratory distress is a common feature of severe malaria and, through sequestration, somnolence, and/or brain swelling, direct central suppression of the respiratory centers leads to irregular breathing patterns in the setting of acidosis, which may contribute to the pH imbalance. Supportive therapy to protect the airway and more aggressively rebalance the pH may decrease mortality (Cheng and Yansouni 2013).