Open AccessHigh‐volume continuous venovenous hemodiafiltration plus resin hemoperfusion improves severe metformin‐associated toxicity
Author(s) -
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
Publication year - 2018
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12757
Subject(s) - medicine , hemoperfusion , metformin , diabetes mellitus , intensive care medicine , hemodialysis , endocrinology
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.