Feeling blue with metformin-associated lactic acidosis. (1st March 2013)

• Record Type: Journal Article
• Authors: Plumb, Benjamin; Parker, Alex; Wong, Paul
• Is Part Of: BMJ case reports. Volume 2013
• Publication Date: 2013-03-01
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2013-008855
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : An active 66-year-old diabetic woman presented with a 5-day history of vomiting and abdominal pain, refractory shock and acute kidney injury (AKI). There was concomitant ACE inhibitor (ACEi) use and metformin toxicity with severe lactic acidosis. She suffered a pulseless electrical activity (PEA) cardiac arrest within 30 min of arrival to the Medical Admissions Unit. Despite a serum pH of 6.57 she was successfully resuscitated. She remained haemodynamically unstable even with fluid resuscitation, inotropic support and haemodiafiltration, yet made a full and rapid recovery following the introduction of a methylene blue infusion.