Fatal Lact?c Ac?dos?s Due To Metform?ne

摘要

A 55 year-old male patient was admitted to emergency department. He ingested 50-60 tablets of 850 mg metformin for suicidal attempt. Blood glucose 352 mg/dL, ALT 52 IU/L, AST 39 IU/L, LDH 441 IU/L, lactate over 181 mg/dL, pH 7.29, pO2 44 mmHg, pCO2 39 mmHg, HCO3 18 mEq/L, oxygen saturation was 74%. Bicarbonate was given by intravenous push at a dose of 1 mEq/kg body weight and the patient was transferred to the intensive care unit. Haemofiltration was performed for lactic acidosis. As a result, haemofiltration should be initiated immediately in patients with acidosis associated with metformin. Thus mortality rates can be lessened.