Circulatory defects during phenformin lactic acidosis

Intensive Care Medicine
M A Latif, M H WEIL


Detailed hemodynamic and metabolic studies were performed during the course of phenformin related lactic acidosis in two patients. Arterial blood lactate was increased to 11.5 and 26.1 mM/L and arterial blood pH was reduced to 7.05 and 6.80 units, respectively. A marked reduction in cardiac indices (0.94 and 1.15 L/min/m2), stroke volume, and stroke work were observed, with either normal or increased arterial resistance. Mild increases in pulmonary artery systolic pressure (50/11), 45/25 mmHg) were observed, but necropsy in both cases disclosed no evidence of pulmonary vascular obstruction. In the absence of increases in central venous and pulmonary artery wedge pressure, a cardiac failure was excluded as primary cause of the low output state. Hypovolemia was excluded on the basis of radioisotope dilution measurements of plasma volume and red cell mass and no increase in cardiac output followed volume expansion. Oxygen extraction from blood was not grossly impaired. These observations indicate that phenformin-related lactic acidosis may evolve as a circulatory defect characteristic of shock in which oxygen delivery rather than oxygen utilization is impaired. The hemodynamic defect is best explained by a defect in the intravascu...Continue Reading


Sep 5, 2012·Nature Reviews. Nephrology·Jeffrey A Kraut, Nicolaos E Madias
Jan 1, 1984·Intensive Care Medicine·Y OzierA Margairaz
Jan 1, 1997·Chest·F JardinJ P Bourdarias
Jun 19, 2007·Journal of Clinical Anesthesia·Alice Wood, Karim Bendjelid
Jun 2, 2005·Current Opinion in Critical Care·F Jardin, Antoine Vieillard-Baron


Mar 24, 1975·JAMA : the Journal of the American Medical Association·M H WEILR Carlson
Sep 4, 1975·The New England Journal of Medicine·M R Taradash, L B Jacobson
Aug 1, 1973·British Heart Journal·M FahlénL Zettergren
Oct 1, 1971·Advances in Experimental Medicine and Biology·M H WEIL, H Shubin
Jun 1, 1968·The American Journal of Physiology·K WildenthalJ H Mitchell
Jul 1, 1967·The American Journal of Physiology·M L NgH A Zieske
Jul 1, 1967·Medical & Biological Engineering·H ShubinM A Rockwell
Oct 1, 1967·Annals of Surgery·L D MacLeanJ H Duff
Nov 1, 1958·Biochimica Et Biophysica Acta·D F STEINER, R H WILLIAMS
Dec 15, 1958·Acta Physiologica Scandinavica·G LILJESTRAND
Nov 26, 1960·British Medical Journal·R S WALKERW S THOMSON
Jul 1, 1962·The Journal of Clinical Investigation·E H BERGOFSKYA P FISHMAN
May 1, 1964·American Heart Journal·R A BRUCEG B STRAIT
Mar 1, 1965·JAMA : the Journal of the American Medical Association·R W HOPKINSF A SIMEONE
Feb 1, 1965·The American Journal of Physiology·S E DOWNINGT H GARDNER

Related Concepts

Arterial Blood pH Measurement
Radionuclide Metabolic Studies
Circulatory System
Metabolic Abnormality Assessment
Thyroid Hormone Plasma Membrane Transport Defect
Plasma Volume Measurement

Trending Feeds


Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Synapse Loss as Therapeutic Target in MS

As we age, the number of synapses present in the human brain starts to decline, but in neurodegenerative diseases this occurs at an accelerated rate. In MS, it has been shown that there is a reduction in synaptic density, which presents a potential target for treatment. Here is the latest research on synapse loss as a therapeutic target in MS.

Artificial Intelligence in Cardiac Imaging

Artificial intelligence (ai) techniques are increasingly applied to cardiovascular (cv) medicine in cardiac imaging analysis. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

Social Learning

Social learning involves learning new behaviors through observation, imitation and modeling. Follow this feed to stay up to date on the latest research.

Cell Atlas of the Human Eye

Constructing a cell atlas of the human eye will require transcriptomic and histologic analysis over the lifespan. This understanding will aid in the study of development and disease. Find the latest research pertaining to the Cell Atlas of the Human Eye here.

Single Cell Chromatin Profiling

Techniques like ATAC-seq and CUT&Tag have the potential to allow single cell profiling of chromatin accessibility, histones, and TFs. This will provide novel insight into cellular heterogeneity and cell states. Discover the latest research on single cell chromatin profiling here.

Genetic Screens in iPSC-derived Brain Cells

Genetic screening is a critical tool that can be employed to define and understand gene function and interaction. This feed focuses on genetic screens conducted using induced pluripotent stem cell (iPSC)-derived brain cells.