Lactic acidosis sorbitol

Infusions of fructose or sorbitol can cause lactic acidosis (425,426), particularly in combination with ethanol. 

Batstone GF, Alberti KG, Dewar AK. Reversible lactic acidosis associated with repeated intravenous infusions of sorbitol and ethanol. Postgrad Med J 1977 53(623) 567-9. 

Fructose has been used as an alternative to dextrose in parenteral nutrition, but its use is not recommended by some because of the risk of lactic acidosis. Although popular in many countries, it has therefore been suggested that the use of intravenous infusions containing fructose and sorbitol should be abandoned. ... 

In a 51-year-old woman, absorption of a solution containing mannitol and sorbitol after irrigation during hysteroscopy led to hypocalcemia and hyponatremia hyperglycemia and lactic acidosis also occurred, because of metabolism of sorbitol [64 ]. 

Some months later, a statement by the Australian Drug Evaluation Committee reflected similar thinking and made closely similar recommendations (52). It was pointed out, inter alia, that the rapid metabolism of fructose and sorbitol can cause rapid accumulation of uric and lactic acids as well as phosphate depletion, especially in states of anoxia, and that acidosis and decreased tissue energy metabolism can occur. Glucose has, among other things, the advantage that it poses no risk to patients with familial laevulose intolerance. 

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