A 74-year-old man with cardiac failure and renal impairment was admitted to the cardiothoracic intensive care unit with metformin-induced lactic acidosis and shock. He was successfully treated with high-dose (80 ml/kg/hour) continuous venovenous haemodiafiltration. Lactic acidosis is a known complication of metformin and is associated with a high mortality. The use of high-dose continuous venovenous haemodiafiltration for this condition has not previously been reported.
GaleaM., JelacinN., BramhamK., WhiteI.Severe lactic acidosis and rhabdomyolysis following metformin and ramipril overdose. Br J Anaesth2007; 98: 213–215.
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LalauJ.D., RaceJ.Lactic acidosis in metformin-treated patients: prognostic value of arterial lactate levels and plasma metformin concentrations. Drug Saf1999; 20: 377–384.
