Extracorporeal treatment of metforminassociated lactic acidosis in clinical practice
| Autor: | Inge R F van Berlo-van de Laar, Frank G A Jansman, Marjo van den Elsen-Hutten, Cornelis G Vermeij, Katja Taxis, Arthur de Meijer |
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| Přispěvatelé: | PharmacoTherapy, -Epidemiology and -Economics, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Extracorporeal treatment CASE SERIES 030226 pharmacology & pharmacy Extracorporeal 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Renal Dialysis Internal medicine medicine Humans Pharmacology (medical) 030212 general & internal medicine Renal replacement therapy Renal impairment Aged Retrospective Studies Aged 80 and over Pharmacology Mechanical ventilation Creatinine business.industry Lactic acidosis RENAL REPLACEMENT THERAPY Retrospective cohort study General Medicine Pharmacokinetics and Disposition Middle Aged medicine.disease Metformin Clinical Practice chemistry Acidosis Lactic Female METFORMIN LEVELS business medicine.drug |
| Zdroj: | European Journal of Clinical Pharmacology, 76(6), 815-820. Springer Verlag European Journal of Clinical Pharmacology |
| ISSN: | 0031-6970 |
| DOI: | 10.1007/s00228-020-02857-5 |
| Popis: | Purpose To assess whether extracorporeal treatment (ECTR) improves outcome of patients with metformin-associated lactic acidosis (MALA) and to evaluate the clinical applicability of the Extracorporeal Treatments in Poisoning Workgroup (EXTRIP) criteria for starting ECTR in metformin poisoning. Methods Patients with metformin serum concentrations above 2 mg/l who were admitted in the Deventer Teaching Hospital between January 2000 and July 2019 and complied with the definition of MALA (pH 5 mmol/l) were included. Mortality and clinical parameters of patients treated with ECTR or not were compared. In addition, treatment of MALA in clinical practice was verified against the criteria of EXTRIP. Results Forty-two patients were included. Lactate (13.8 versus 10.5 mmol/l, p = 0.01), creatinine (575 versus 254 umol/l, p p p p = 0.03) and bicarbonate (6 versus 11 mmol/l, p Conclusions Although there was no statistical benefit in mortality shown from ECTR, ECTR might be lifesaving in MALA, considering the ECTR-group was significantly sicker than the non-ECTR-group. The majority of patients were treated in line with the EXTRIP criteria. Severity of lactic acidosis and renal impairment were the main indications for initiating ECTR. |
| Databáze: | OpenAIRE |
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