Continuous veno-venous hemofiltration in patients with metformin associated lactic acidosis

Metformin is frequently used by type II diabetics. A rare complication of its use is metformin associated lactic acidosis (MALA). This condition is often accompanied by extreme metabolic acidosis and hemodynamic instability for which ICU treatment is mandatory. Guidelines advice intermittent hemodialysis for correction of metabolic acidosis and to clear metformin. However, haemodynamic instability may prefer continuous veno-venous hemofiltration (CVVH). We evaluated the effect of CVVH in critically ill patients admitted with MALA.