A case of metformin-associated lactic acidosis with cardiogenic and vasoplegic shock supported by ECPella

Metfomin-associated lactic acidosis (MALA) is a rare but life-threatening complication of metformin use. We present a case of MALA with concurrent cardiogenic and vasoplegic shock which was successfully supported by ECPella (concurrent use of VA-ECMO and Impella). Early recognition, aggressive hemod...

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Veröffentlicht in:	Perfusion 2024-09, Vol.39 (6), p.1265-1269
Hauptverfasser:	Ling, Steven Kin-ho, Chung, Kit Wang, Ma, Hei Yee
Format:	Artikel
Sprache:	eng
Schlagworte:	Acidosis Acidosis, Lactic - chemically induced Acidosis, Lactic - therapy Extracorporeal Membrane Oxygenation - methods Female Hemodialysis Hemodynamics Humans Lactic acidosis Male Metformin Metformin - adverse effects Metformin - therapeutic use Middle Aged Shock, Cardiogenic - chemically induced Shock, Cardiogenic - therapy Vasoplegia - drug therapy
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Zusammenfassung:	Metfomin-associated lactic acidosis (MALA) is a rare but life-threatening complication of metformin use. We present a case of MALA with concurrent cardiogenic and vasoplegic shock which was successfully supported by ECPella (concurrent use of VA-ECMO and Impella). Early recognition, aggressive hemodynamic support with ECPella and early hemodialysis can be life-saving. Monitoring of both lactate and SvO2 trends can help understand the response to treatment.
ISSN:	0267-6591 1477-111X 1477-111X
DOI:	10.1177/02676591231181851