Calello et al reported indications for extracorporeal therapy in a patient poisoned with metformin. The authors are from the Extracorporeal Treatments in Poisoning Workgroup.
Patient selection: meformin poisoning
Modes of extracorporeal therapy:
(1) intermittent hemodialysis
(2) continuous renal replacement therapy (CRRT)
Indications for extracorporeal therapy:
(1) serum lactate concentration > 20 mmol/L
(2) arterial pH <= 7.0
(3) shock
(4) decreased level of consciousness
(5) failure of standard supportive measures
Goals of therapy - both of the following:
(1) serum lactate < 3 mmol/L
(2) pH > 7.35
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