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The management of metformin overdose
Author(s) -
Teale K. F. H.,
Devine A.,
Stewart H.,
Harper N. J. H.
Publication year - 1998
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.1998.436-az0549.x
Subject(s) - medicine , metformin , lactic acidosis , metabolic acidosis , sodium bicarbonate , acidosis , intensive care medicine , anesthesia , insulin , chemistry
Only two cases of deliberate self‐poisoning with metformin have been described in the literature. We report the management of three cases, all of which presented with severe lactic acidosis. Two cases had a fatal outcome. The options for treatment and previous cases reported in the literature are reviewed. Recommendations for the management of metformin overdose include early recognition, intensive support of the cardiovascular system, the correction of metabolic acidosis and the maintenance of body temperature. The use of venovenous haemofiltration against a non‐lactate containing fluid may improve outcome when sodium bicarbonate alone fails to reverse severe systemic acidosis.