Ulus Travma Acil Cerrahi Derg. 2021; 27(5): 595-599 | DOI: 10.14744/tjtes.2020.27367

Suisid giriþiminin neden olduðu metformin-iliþkili laktik asidozda sürekli venö-venöz hemodiyafiltrasyon: Ýki olgu sunumu

Bahattin Tuncali¹, Ayþe Gül Temizkan Kýrkayak², Pýnar Zeyneloðlu^1
1Baþkent Üniversitesi Týp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalý, Ankara
²Baþkent Üniversitesi Týp Fakültesi, Nefroloji Bilim Dalý, Ankara

Tip 2 diyabetes mellitus tedavisinde yaygýn þekilde kullanýlan metforminin en önemli ve hayatý tehdit eden yan etkisi laktik asidozdur. Bu olgu sunumu ile intihar amaçlý yüksek doz metformin alýmýna baðlý laktik asidoz nedeniyle yoðun bakýmýmýzda tedavi edilen iki olgu sunulmuþtur. Olgulardan biri sürekli venö-venöz hemodiyafiltrasyon (CVVHDF) ve destek tedavisi ile baþarýlý bir þekilde tedavi edilebilmiþtir. Diðer olguda gecikmiþ tedavi nedeniyle CVVHDF ve destek tedavi yanýnda endotrakeal entübasyon ve mekanik ventilasyon gereksinimi olmuþtur.

Anahtar Kelimeler: Laktik asidoz, metformin zehirlenmesi; sürekli venö-venöz hemodiyafiltrasyon.

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Continuous veno-venous hemodiafiltration in metformin-associated lactic acidosis caused by a suicide attempt: A report of two cases

Bahattin Tuncali¹, Ayþe Gül Temizkan Kýrkayak², Pýnar Zeyneloðlu^1
1Department of Anesthesiology and Reanimation, Baþkent University Faculty of Medicine, Ankara-Turkey
²Department of Nephrology, Baþkent University Faculty of Medicine, Ankara-Turkey

Lactic acidosis is the most important and life-threatening side effect of metformin that is widely used in the treatment of type 2 diabetes mellitus. In this case report, two cases who were treated in our intensive care unit for lactic acidosis due to high-dose metformin intake for suicidal purposes are presented. The first patient could be successfully treated with continuous venous-venous hemodiafiltration (CVVHDF) and supportive therapy. The second case required endotracheal intubation and mechanical ventilation in addition to CVVHDF and supportive therapy due to delay in treatment.

Keywords: Continuous veno-venous hemodiafiltration, lactic acidosis; metformin poisoning.

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