Extracorporeal treatment with high-volume continuous venovenous hemodiafiltration and charcoal-based sorbent hemoperfusion for severe metformin-associated lactic acidosis.
We present a case of a 49-year-old female with an alleged history of ingestion of approximately 100 tablets of metformin (850 mg each). Investigations revealed severe lactic acidosis with lactate levels of 13.5 mmol/L and pH of 7.17. This indicates severe toxicity and is associated with a high mortality. Charcoal-based sorbent hemoperfusion was done as a desperate effort, as patient continued to deteriorate despite supportive care and high-volume continuous venovenous hemodiafiltration. The patient survived despite metformin-associated lactic acidosis related to severe metformin toxicity.
Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, New Delhi, India.
Suneel Kumar
SK
Garg
Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, New Delhi, India.
Omender
O
Singh
Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, New Delhi, India.
Desh
D
Deepak
Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, New Delhi, India.
Akhilesh
A
Singh
Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, New Delhi, India.
Rohit
R
Yadav
Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, New Delhi, India.
Kirti
K
Vashist
Charcoal hemoperfusion; extracorporeal; metformin