Metformin is a biguanid and because of its effects in decreasing the
production of glucose in liver and in increasing the sensitivity of insulin
in peripheral tissues like adipose tissue and skeletal muscle, it is used in
metabolic syndrome and type 2 diabetes mellitus which insulin resistance
is especially pronounced. The most important side effect of metformin is
lactic acidosis. Lactic acidosis is the most frequent cause of hospitalized
patients with metabolic acidosis. Especially renal dysfunction, liver
disease, and in patients with risk factors such as heavy alcohol intake; It is
recognized as a potential complication of metformin lactic acidosis. As a
result, it can cause cardiopulmonary arrest. Systemic hypoxemia, sepsis,
dehydration, old age and overdose cases increases in these complications.
A 60 year-old female patient applied to the emergency service because of
the widespread burning body ache and general condition disorder. Results
of examinations and laboratory; has been identified in patients with severe
renal insufficiency and leukocytosis and invested with the suspecting of
sepsis and was admitted to the intensive care unit. Mechanic ventilation
and continuous venovenous hemofiltration was performed under deep
sedation. Volume replacement, vasopressor and antibiotic therapy were
also performed. Finally she was discharged to the service without any
squelle.

Metformin induced lactic acidosis - a case report