[Lactic acidosis shock. Report of a clinical case].
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.
Venturini
E
E
Unità Ospedaliera Malattie Cardiovascolari, Ospedale di Volterra, Pisa.
Francardelli
L
L
Piccoli
M
M
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
D001645:Biguanides; D007004:Hypoglycemic Agents; D004280:Dobutamine; D010629:Phenformin
Shock da acidosi lattica. Descrizione di un caso clinico.