Metformin Zehirlenmesinde Sürekli Renal Replasman Tedavinin Etkinliği: Olgu Sunumu

Year 2024, , 385 - 390, 14.10.2024

Kiraz Tekin Günaydın , Ahmet Şen , Ahmet Akyol

https://doi.org/10.52827/hititmedj.1436657

Abstract

Metformin ilişkili laktik asidoz böbrek yetmezliği, karaciğer yetmezliği, sepsis, septik şok gibi hemodinamiyi bozan durumlarda ya da akut zehirlenmelerde görülür. Metformin ilişkili laktik asidozun mortalitesi yüksek olduğu için erken tanı ve tedavi mortaliteyi azaltmakta önemlidir. Sürekli renal replasman tedavisi özellikle hemodinamik anstabilite ile seyreden ciddi metabolik asidoz, zehirlenme, hiperkalemi, aşırı volüm yükü gibi klinik durumlarda tercih edilmektedir. Metformin zehirlenmesine bağlı gelişen laktik asidozlu olgumuzda iki kez aralıklı hemodiyaliz uygulanmasına rağmen yanıt alınamaması ve hemodinamik anstabilitesi olması nedeniyle hastaya uygulanan sürekli renal replasman tedavisinin etkinliğini vurgulamayı amaçladık.

Keywords

Metformin, Sürekli renal replasman tedavisi, Yoğun bakım, Zehirlenme

Ethical Statement

Hastanın onamı alınmıştır.

Supporting Institution

Herhangi bir kurum tarafından desteklenmemiştir.

Efficacy of Continuous Renal Replacement Therapy in Metformin Intoxication: Case Report

Abstract

Metformin-associated lactic acidosis is seen in conditions that disrupt haemodynamics such as renal failure, hepatic failure, sepsis, septic shock or in acute poisoning. Since the mortality rate of metformin-associated lactic acidosis is high, early diagnosis and treatment is important in reducing mortality. Continuous renal replacement therapy is preferred especially in clinical conditions such as severe metabolic acidosis with haemodynamic instability, intoxication, hyperkalaemia and volume overload. In our patient with lactic acidosis due to metformin intoxication, we aimed to emphasise the efficacy of continuous renal replacement therapy because of the lack of response despite two intermittent haemodialysis and haemodynamic instability.

Keywords

Continuous renal replacement therapy, Critical care, Metformin, Poisoning

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