tailieunhanh - Báo cáo y học: "Should dialysis be offered in all cases of metformin-associated lactic acidosis"

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: Should dialysis be offered in all cases of metformin-associated lactic acidosis? | Available online http content 13 1 110 Commentary Should dialysis be offered in all cases of metformin-associated lactic acidosis S Neil Finkle Capital Health 5089 Dickson Centre 5820 University Avenue Halifax Nova Scotia Canada B3H 1V8 Corresponding author S Neil Finkle Published 9 January 2009 This article is online at http content 13 1 110 2009 BioMed Central Ltd Critical Care 2009 13 110 doi cc7161 See related research by Peters et al. http content 12 6 R149 Abstract Metformin is commonly used in diabetes mellitus type 2 with lactic acidosis being a rare but potentially fatal complication of this therapy. The management of metformin-associated lactic acidosis MALA is controversial. Treatment may include supportive care activated charcoal bicarbonate infusion hemodialysis or continuous venovenous hemofiltration. In the previous issue of Critical Care Peters and colleagues systematically evaluated outcomes in MALA patients admitted to their intensive care unit. The mortality rate of patients who received dialysis was similar to that of patients who were not dialyzed. However it was the more acutely and chronically ill patients who actually received dialysis. This suggests that hemodialysis was beneficial in preventing a higher mortality rate in those who required renal replacement therapy. The literature on the management of metformin-associated lactic acidosis MALA is sparse and consists of case reports and case series. In the previous issue of Critical Care Peters and colleagues 1 presented a retrospective cohort study in patients with MALA. This study represents an important step forward in systematically evaluating outcomes in this rare but serious condition. Metformin is commonly used in type 2 diabetes mellitus and accounts for approximately one third of all prescriptions for oral hypoglycemic agents in the US 2 . The United Kingdom Prospective Diabetes Study demonstrated impressive .