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Outcome of severe lactic acidosis associated with metformin accumulation
INTRODUCTION: Metformin associated lactic acidosis (MALA) may complicate metformin therapy, particularly if metformin accumulates due to renal dysfunction. Profound lactic acidosis (LA) generally predicts poor outcome. We aimed to determine if MALA differs in outcome from LA of other origin (LAOO)....
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3220003/ https://www.ncbi.nlm.nih.gov/pubmed/21171991 http://dx.doi.org/10.1186/cc9376 |
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author | Friesecke, Sigrun Abel, Peter Roser, Markus Felix, Stephan B Runge, Soeren |
author_facet | Friesecke, Sigrun Abel, Peter Roser, Markus Felix, Stephan B Runge, Soeren |
author_sort | Friesecke, Sigrun |
collection | PubMed |
description | INTRODUCTION: Metformin associated lactic acidosis (MALA) may complicate metformin therapy, particularly if metformin accumulates due to renal dysfunction. Profound lactic acidosis (LA) generally predicts poor outcome. We aimed to determine if MALA differs in outcome from LA of other origin (LAOO). METHODS: We conducted a retrospective analysis of all patients admitted with LA to our medical ICU of a tertiary referral center during a 5-year period. MALA patients and LAOO patients were compared with respect to parameters of acid-base balance, serum creatinine, hospital outcome, Simplified Acute Physiology Score II (SAPS II) and Sequential Organ Failure Assessment (SOFA) score, using Pearson's Chi-square or the Mann-Whitney U-test. RESULTS: Of 197 patients admitted with LA, 10 had been diagnosed with MALA. With MALA, median arterial blood pH was significantly lower (6.78 [range 6.5 to 6.94]) and serum lactate significantly higher (18.7 ± 5.3 mmol/L) than with LAOO (pH 7.20 [range 6.46 to 7.35], mean serum lactate 11.2 ± 6.1 mmol/L). Overall mortality, however, was comparable (MALA 50%, LAOO 74%). Furthermore, survival of patients with arterial blood pH < 7.00 (N = 41) was significantly better (50% vs. 0%) if MALA (N = 10) was the underlying condition compared to LAOO (N = 31). CONCLUSIONS: Compared to similarly severe lactic acidosis of other origin, the prognosis of MALA is significantly better. MALA should be considered in metformin-treated patients presenting with lactic acidosis. |
format | Online Article Text |
id | pubmed-3220003 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-32200032011-11-18 Outcome of severe lactic acidosis associated with metformin accumulation Friesecke, Sigrun Abel, Peter Roser, Markus Felix, Stephan B Runge, Soeren Crit Care Research INTRODUCTION: Metformin associated lactic acidosis (MALA) may complicate metformin therapy, particularly if metformin accumulates due to renal dysfunction. Profound lactic acidosis (LA) generally predicts poor outcome. We aimed to determine if MALA differs in outcome from LA of other origin (LAOO). METHODS: We conducted a retrospective analysis of all patients admitted with LA to our medical ICU of a tertiary referral center during a 5-year period. MALA patients and LAOO patients were compared with respect to parameters of acid-base balance, serum creatinine, hospital outcome, Simplified Acute Physiology Score II (SAPS II) and Sequential Organ Failure Assessment (SOFA) score, using Pearson's Chi-square or the Mann-Whitney U-test. RESULTS: Of 197 patients admitted with LA, 10 had been diagnosed with MALA. With MALA, median arterial blood pH was significantly lower (6.78 [range 6.5 to 6.94]) and serum lactate significantly higher (18.7 ± 5.3 mmol/L) than with LAOO (pH 7.20 [range 6.46 to 7.35], mean serum lactate 11.2 ± 6.1 mmol/L). Overall mortality, however, was comparable (MALA 50%, LAOO 74%). Furthermore, survival of patients with arterial blood pH < 7.00 (N = 41) was significantly better (50% vs. 0%) if MALA (N = 10) was the underlying condition compared to LAOO (N = 31). CONCLUSIONS: Compared to similarly severe lactic acidosis of other origin, the prognosis of MALA is significantly better. MALA should be considered in metformin-treated patients presenting with lactic acidosis. BioMed Central 2010 2010-12-20 /pmc/articles/PMC3220003/ /pubmed/21171991 http://dx.doi.org/10.1186/cc9376 Text en Copyright ©2010 Friesecke et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (<url>http://creativecommons.org/licenses/by/2.0</url>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Friesecke, Sigrun Abel, Peter Roser, Markus Felix, Stephan B Runge, Soeren Outcome of severe lactic acidosis associated with metformin accumulation |
title | Outcome of severe lactic acidosis associated with metformin accumulation |
title_full | Outcome of severe lactic acidosis associated with metformin accumulation |
title_fullStr | Outcome of severe lactic acidosis associated with metformin accumulation |
title_full_unstemmed | Outcome of severe lactic acidosis associated with metformin accumulation |
title_short | Outcome of severe lactic acidosis associated with metformin accumulation |
title_sort | outcome of severe lactic acidosis associated with metformin accumulation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3220003/ https://www.ncbi.nlm.nih.gov/pubmed/21171991 http://dx.doi.org/10.1186/cc9376 |
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