EUROPEAN JOURNAL OF EMERGENCY MEDICINE, cilt.16, sa.1, ss.11-13, 2009 (SCI-Expanded, Scopus)
Background Biguanides pose a significant risk of morbidity, mortality and permanent sequelae secondary to prolonged periods of hypoglycaemia. Objectives To investigate the treatment of massive metformin overdose associated with lactic acidosis. Case report We present the case of a 30-year-old woman, who attempted to commit suicide by ingesting an 85-g massive metformin overdose associated with severe lactic acidosis, which we treated by performing prolonged haemodialysis with bicarbonate and plasma exchange. Conclusion For the maximum elimination of metformin, extended haemodialysis is required and the treatment of the accompanying metabolic acidosis with bicarbonate is important for the effectiveness of the treatment. Patients benefit much more from the treatment of combined haemodialysis with plasma exchange. European Journal of Emergency Medicine 16:11-13 (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.