Feeling Blue with Metformin-associated Lactic Acidosis

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2013 Mar 5

PMID 23456165

Citations 7

Authors

Benjamin Plumb

Alex Parker

Paul Wong

Affiliations

Soon will be listed here.

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.

Citing Articles

Metformin-Associated Lactic Acidosis in an Older Adult: A Case Report and Review.

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Successful use of methylene blue for catecholamine-refractory vasoplegic shock due to metformin intoxication: A case report and literature review.

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Methylene blue as treatment for vasoplegic shock in severe metformin overdose: A case report.

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Methylene blue: a controversial diagnostic acid and medication?.

Buzga M, Machytka E, Dvorackova E, Svagera Z, Stejskal D, Maca J Toxicol Res (Camb). 2022; 11(5):711-717.

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Refractory vasodilatory shock secondary to metformin overdose supported with VA ECMO.

Tallman C, Zhang Y, Black N, Lynch K, Fayed M, Armenian P Toxicol Rep. 2022; 9:64-67.

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