Abstract:
INTRODUCTION:Metformin-associated lactic acidosis (MALA) is a classic side effect of metformin and is known to be a severe disease with a high mortality rate. The treatment of MALA with dialysis is controversial and is the subject of many case reports in the literature. We aimed to assess the prevalence of MALA in a 16-bed, university-affiliated, intensive care unit (ICU), and the effect of dialysis on patient outcome. METHODS:Over a five-year period, we retrospectively identified all patients who were either admitted to the ICU with metformin as a usual medication, or who attempted suicide by metformin ingestion. Within this population, we selected patients presenting with lactic acidosis, thus defining MALA, and described their clinical and biological features. RESULTS:MALA accounted for 0.84% of all admissions during the study period (30 MALA admissions over five years) and was associated with a 30% mortality rate. The only factors associated with a fatal outcome were the reason for admission in the ICU and the initial prothrombin time. Although patients who went on to haemodialysis had higher illness severity scores, as compared with those who were not dialysed, the mortality rates were similar between the two groups (31.3% versus 28.6%). CONCLUSIONS:MALA can be encountered in the ICU several times a year and still remains a life-threatening condition. Treatment is restricted mostly to supportive measures, although haemodialysis may possess a protective effect.
journal_name
Crit Carejournal_title
Critical care (London, England)authors
Peters N,Jay N,Barraud D,Cravoisy A,Nace L,Bollaert PE,Gibot Sdoi
10.1186/cc7137subject
Has Abstractpub_date
2008-01-01 00:00:00pages
R149issue
6eissn
1364-8535issn
1466-609Xpii
cc7137journal_volume
12pub_type
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