Lactic acidosis and severe septic shock in metformin users: a cohort study

Critical Care : the Official Journal of the Critical Care Forum
Keren Doenyas-BarakShai Efrati

Abstract

High serum lactate is associated with increased mortality in septic shock patients. Metformin alters lactate metabolism, and may affect its prognostic value. We compared, between metformin users and nonusers, the prognosis of extremely elevated plasma lactate levels in patients with septic shock. The electronic medical records (EMR) of patients admitted to the emergency room between January 2011 and June 2013 were reviewed. The study cohort comprised patients with an initial diagnosis of septic shock and blood lactate higher than 10 mmol/L. The selected population was divided into two groups: metformin users (exposed) and metformin nonusers (unexposed). The primary outcome measured was inhospital mortality. The study included 44 metformin users and 118 nonusers. Metformin users were similar to nonusers with respect to levels of lactate, HCO3, and blood pH; however, they were older and had higher incidence rates of cardiovascular disease and acute kidney injury at admission, compared to nonusers. Inhospital mortality rates were significantly lower in the metformin-treated group, 56.8 % vs. 88.1 %, p <0.0001. Though high lactate concentration indicates poor prognosis in septic patients, mortality rate was found to be significantl...Continue Reading

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Citations

May 8, 2016·Critical Care : the Official Journal of the Critical Care Forum·Patrick M Honore, Herbert D Spapen
Jun 2, 2016·Critical Care : the Official Journal of the Critical Care Forum·Rene A PosmaMaarten W N Nijsten
Dec 23, 2017·Diabetes/metabolism Research and Reviews·Faiza MalikJesse Roth
Nov 8, 2018·Antioxidants & Redox Signaling·Vera A ReitsemaHjalmar R Bouma
Apr 30, 2020·Critical Care : the Official Journal of the Critical Care Forum·Patrick M HonoreDavid De Bels
Dec 4, 2019·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Jean-Daniel LalauMarc De Broe
Oct 16, 2020·Expert Opinion on Pharmacotherapy·Syed Shahzad HasanMuhammad Abdul Hadi

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