CVVH + Hemoperfusion Effective in Severe Metformin-Associated Toxicity

Patient was treated with high-volume continuous venovenous hemodiafiltration and resin-sorbent hemoperfusion
Patient was treated with high-volume continuous venovenous hemodiafiltration and resin-sorbent hemoperfusion

(HealthDay News) — High-volume continuous venovenous hemodiafiltration (CVVH) and resin-sorbent hemoperfusion is effective for eliminating metformin, according to a case study published online Oct. 5 in the Journal of Diabetes Investigation.

Shuangxin Liu, from Guangdong Academy of Medical Sciences in China, and colleagues described the case of a 42-year-old female who attempted suicide by taking 100 tablets of 500 mg metformin. Severe lactic acidosis was revealed in laboratory tests, with lactate levels of 24 mmol/L and pH of 7.09.

The researchers noted that the patient was treated with high-volume CVVH and resin-sorbent hemoperfusion. During CVVH and hemoperfusion treatment, metformin concentrations were assessed with high-performance liquid chromatography. Plasma metformin concentration was 208.5 mg/L before extracorporeal treatment and decreased to 13.9 mg/L after 24 hours of CVVH treatment. After three hours, resin-based sorbent hemoperfusion plus CVVH treatment had reduced metformin plasma concentration by 61.8 percent. The patient's laboratory tests and clinical syndrome were improved after seven days, and she was discharged.

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"We provide evidence that CVVH plus hemoperfusion is effective in eliminating metformins and metabolic products," the authors write.

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