tailieunhanh - Báo cáo y học: " Outcome of severe lactic acidosis associated with metformin accumulation"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Outcome of severe lactic acidosis associated with metformin accumulation. | Friesecke et al. Critical Care 2010 14 R226 http content 14 6 R226 KS CRITICAL CARE RESEARCH Open Access Outcome of severe lactic acidosis associated with metformin accumulation 1 1 2 1 3 Sigrun Friesecke Peter Abel Markus Roser Stephan B Felix Soeren Runge Abstract 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 range to and serum lactate significantly higher mmol L than with LAOO pH range to mean serum lactate mmol L . Overall mortality however was comparable MALA 50 LAOO 74 . Furthermore survival of patients with arterial blood pH 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. Introduction Metformin is recommended as the treatment of choice in patients with type 2 diabetes mellitus because it decreases cardiovascular morbidity and mortality 1 2 . Nevertheless metformin-associated lactic acidosis MALA is a rare but potentially life-threatening .