title: [Lactic acidosis shock. Report of a clinical case].
abstract: Lactic acidosis is a severe metabolic disorder with multiple pathogenesis; biguanides increase serum lactate. The authors describe a case of phenformin-associated acidosis enhanced by predisposing conditions (dilated cardiomyopathy, renal failure, hypothyroidism). Causative mechanisms and consequences on production/clearance lactic acid cycle are discussed. The benefits of hemodialysis and inotropic therapy (dobutamine) are emphasized. Treatment of critically ill patients must be designed to avoid increase in serum lactate.
authors.affiliation: Unità Ospedaliera Malattie Cardiovascolari, Ospedale di Volterra, Pisa.
authors.forename: E
authors.initials: E
authors.lastname: Venturini
authors.forename: L
authors.initials: L
authors.lastname: Francardelli
authors.forename: M
authors.initials: M
authors.lastname: Piccoli
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced / Q000150:complications* / Q000628:therapy; D058186:Acute Kidney Injury / Q000150:complications; D000368:Aged; D001645:Biguanides / Q000009:adverse effects; D002311:Cardiomyopathy, Dilated / Q000150:complications; D004280:Dobutamine / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D010629:Phenformin / Q000009:adverse effects*; D006435:Renal Dialysis; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000628:therapy
chemical_list: D001645:Biguanides; D007004:Hypoglycemic Agents; D004280:Dobutamine; D010629:Phenformin
vernacular_title: Shock da acidosi lattica. Descrizione di un caso clinico.