Abstract

SANCHEZ-DIAZ, Jesus Salvador et al. Metformin-related lactic acidosis: Case report. Rev. colomb. anestesiol. [online]. 2017, vol.45, n.4, pp.353-359. ISSN 0120-3347.

Lactic acidosis is defined as the presence of pH <7.35, blood lactate >2.0 mmol/L and PaCO2 <42 mmHg. However, the definition of severe lactic acidosis is controversial. The primary cause of severe lactic acidosis is shock. Although rare, metformin-related lactic acidosis is associated with a mortality as high as 50%. The treatment for metabolic acidosis, including lactic acidosis, may be specific or general, using sodium bicarbonate, trihydroxyaminomethane, carbicarb or continuous haemodiafiltration. The successful treatment of lactic acidosis depends on the control of the aetiological source. Intermittent or continuous renal replacement therapy is perfectly justified, shock being the argument for deciding which modality to use. We report a case of a male patient presenting with metformin poisoning as a result of attempted suicide, who developed lactic acidosis and multiple organ failure. The critical success factor was treatment with continuous haemodiafiltration.

Keywords : Acidosis; lactic; Metformin; Sodium bicarbonate; Renal replacement therapy; Lactic acid.

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