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VOLUME 20 , ISSUE 5 ( 2016 ) > List of Articles


Extracorporeal treatment with high-volume continuous venovenous hemodiafiltration and charcoal-based sorbent hemoperfusion for severe metformin-associated lactic acidosis

Desh Deepak, Suneel Kumar Garg, Akhilesh Singh, Kirti Vashist

Keywords : Charcoal hemoperfusion, extracorporeal, metformin

Citation Information : Deepak D, Garg SK, Singh A, Vashist K. Extracorporeal treatment with high-volume continuous venovenous hemodiafiltration and charcoal-based sorbent hemoperfusion for severe metformin-associated lactic acidosis. Indian J Crit Care Med 2016; 20 (5):295-298.

DOI: 10.4103/0972-5229.182205

License: CC BY-ND 3.0

Published Online: 01-12-2013

Copyright Statement:  Copyright © 2016; The Author(s).


We present a case of a 49-year-old female with an alleged history of ingestion of approximately 100 tablets of metformin (850 mg each). Investigations revealed severe lactic acidosis with lactate levels of 13.5 mmol/L and pH of 7.17. This indicates severe toxicity and is associated with a high mortality. Charcoal-based sorbent hemoperfusion was done as a desperate effort, as patient continued to deteriorate despite supportive care and high-volume continuous venovenous hemodiafiltration. The patient survived despite metformin-associated lactic acidosis related to severe metformin toxicity.

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