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KMID : 1037620230100040149
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Pediatric Emergency Medicine Journal
2023 Volume.10 No. 4 p.149 ~ p.154
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An adolescent female with intentional ingestion of a large amount of metformin requiring extracorporeal membrane oxygenation and continuous renal replacement therapy
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Kaila Lessner
Lauren McKinney
Ilana Anderson
Chie-Youn Shih
J. Bryan Carmody
Meaghan Dominy
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Abstract
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Acute overdose of metformin can show potentially fatal lactic acidosis. Management should be directed towards close monitoring of renal function and hemodynamics. Patients may require dialysis or extracorporeal membrane oxygenation in cases of hemodynamic instability. This case presents an adolescent with massive metformin ingestion estimated at 100 g leading to metformin-associated lactic acidosis and subsequent respiratory failure, cardiovascular collapse, and acute kidney injury. The complications were successfully managed with venoarterial extracorporeal membrane oxygenation, continuous renal replacement therapy, and mechanical ventilation.
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KEYWORD
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Acidosis, Lactic, Adolescent, Dialysis, Extracorporeal Membrane Oxygenation, Metformin, Poisons
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