High‐volume continuous venovenous hemodiafiltration plus resin hemoperfusion improves severe metformin‐associated toxicity. Issue 4 (6th December 2017)

• Record Type: Journal Article
• Authors: Liu, Shuangxin; Xu, Lixia; Ma, Jianchao; Huang, Renwei; Lin, Ting; Li, Zhuo; Liang, Huabang; Li, Sijia; Li, Ruizhao; Zhang, Li; Tao, Yiming; Li, Zhilian; Chen, Yuanhan; Ye, Zhiming; Zhang, Bin; Wang, Wenjian; Xiao, Houqing; Liang, Xinling; Shi, Wei
• Is Part Of: Journal of diabetes investigation. Volume 9:Issue 4(2018)
• Page Start: 975
• Page End: 978
• Publication Date: 2017-12-06
• Subjects: Continuous venovenous hemodiafiltration -- Hemoperfusion -- Metformin overdose; Diabetes -- Periodicals; Diabetes -- Research -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1111/jdi.12757
• Languages: English
• ISSNs: 2040-1116

Abstract

Abstract: We present the case of a 42‐year‐old female patient who attempted suicide by taking approximately 100 tablets of metformin (500 mg). Laboratory tests revealed severe lactic acidosis with lactate levels of 24 mmol/L and pH of 7.09. The patient was treated with high‐volume continuous venovenous hemodiafiltration (CVVH) and resin‐sorbent hemoperfusion. Metformin concentrations were measured by high‐performance liquid chromatography during CVVH and hemoperfusion treatment. Before extracorporeal treatment, the plasma metformin concentration was 208.5 mg/L. After CVVH treatment for 24 h, the plasma metformin concentration had decreased to 13.9 mg/L. Resin‐based sorbent hemoperfusion plus CVVH treatment had reduced the metformin plasma concentration by 61.8% after 3 h. After 7 days, the patient's laboratory tests and clinical syndrome were improved, and she was discharged from hospital. We provide evidence that CVVH plus hemoperfusion is effective in eliminating metformins and metabolic products. Abstract : The patients with metformin overdose should be treated with extracorporeal therapy. Combination of CVVH and hemoperfusion eliminated more metformin and metabolic products, and improved arterial blood pressure, hypoglycemia and lactate in treatment metformin overdose.