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Metformin-associated lactic acidosis requiring intensive care in a regional hospital in Hong Kong and predictive factors for mortality
Chung-Tat Lun, Henry Jeffrey Yuen, George Ng, Sheung-On So, Anne Leung, Kang-Yiu LaiIndian Journal of Critical Care Medicine 2017 21(12):875-877
Source: Indian Journal of Critical Care Medicine - December 14, 2017 Category: Intensive Care Authors: Chung-Tat Lun Henry Jeffrey Yuen George Ng Sheung-On So Anne Leung Kang-Yiu Lai Source Type: research

Extracorporeal treatment with high-volume continuous venovenous hemodiafiltration and charcoal-based sorbent hemoperfusion for severe metformin-associated lactic acidosis
We present a case of a 49-year-old female with an alleged history of ingestion of approximately 100 tablets of metformin (850 mg each). Investigations revealed severe lactic acidosis with lactate levels of 13.5 mmol/L and pH of 7.17. This indicates severe toxicity and is associated with a high mortality. Charcoal-based sorbent hemoperfusion was done as a desperate effort, as patient continued to deteriorate despite supportive care and high-volume continuous venovenous hemodiafiltration. The patient survived despite metformin-associated lactic acidosis related to severe metformin toxicity.
Source: Indian Journal of Critical Care Medicine - May 9, 2016 Category: Intensive Care Authors: Suneel Kumar GargOmender SinghDesh DeepakAkhilesh SinghRohit YadavKirti Vashist Source Type: research

Hyperglycemia in the intensive care unit: is insulin the only option?
Current guidelines advocate the use of insulin for the management of hyperglycemia in the hospital setting. However, insulin is limited by a narrow therapeutic window, frequent errors, a need for expertise and systems-based monitoring, and lack of specificity for metabolic abnormalities that occur during critical illness. As a result, non-insulin alternatives have garnered increasing interest for managing hyperglycemia in the hospital. However, non-insulin therapies have had safety and tolerability concerns, patients may still need insulin for glycemic control, and there have been limited outcomes data supporting their use...
Source: Critical Care - November 13, 2013 Category: Intensive Care Authors: Kathleen Dungan Source Type: research

Evidence for Right Ventricular Lipotoxicity in Heritable Pulmonary Arterial Hypertension.
Conclusions: These data demonstrate that Bmpr2 mutation affects RV stress responses in a transgenic rodent model. Impaired RV hypertrophy and triglyceride and ceramide deposition are present as a function of RV mutant Bmpr2 in mice; fatty acid oxidation impairment in human HPAH RVs may underlie this finding. Further study of how BMPR2 mediates RV lipotoxicity is warranted. PMID: 24274756 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - November 25, 2013 Category: Respiratory Medicine Authors: Hemnes AR, Brittain EL, Trammell AW, Fessel JP, Austin ED, Penner N, Maynard KB, Gleaves L, Talati M, Absi T, Disalvo T, West J Tags: Am J Respir Crit Care Med Source Type: research

Survival of Stage IV Lung Cancer Patients with Diabetes Treated with Metformin.
Conclusions: Metformin is associated with improved survival among diabetic patients with stage IV NSCLC suggesting a potential anticancer effect. Further research should evaluate plausible biological mechanisms as well as test the effect of metformin in prospective clinical trials. PMID: 25522257 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - December 18, 2014 Category: Respiratory Medicine Authors: Lin JJ, Gallagher EJ, Sigel K, Mhango G, Galsky MD, Smith CB, LeRoith D, Wisnivesky JP Tags: Am J Respir Crit Care Med Source Type: research

Metformin Therapy for Pulmonary Hypertension Associated with HFpEF versus PAH.
PMID: 29727194 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - May 4, 2018 Category: Respiratory Medicine Authors: Goncharov DA, Goncharova EA, Tofovic SP, Hu J, Baust JJ, Pena AZ, Ray A, Rode A, Vanderpool RR, Mora AL, Gladwin MT, Lai YC Tags: Am J Respir Crit Care Med Source Type: research

Anabolic and anticatabolic agents in critical care
Purpose of review: A complex network of hormones and other effectors characterize the hypermetabolic response in critical illness; these mediators work together to induce numerous pathophysiologic alterations. Increased incidence of infection, multiorgan failure, long-term debilitation, delays in rehabilitation, and death result from an inability to meet the prohibitively elevated protein and energy requirements, which occur during illness and can persist for several years. Pharmacologic interventions have been successfully utilized to attenuate particular aspects of the hypermetabolic response; these modalities are a comp...
Source: Current Opinion in Critical Care - July 1, 2016 Category: Nursing Tags: METABOLIC SUPPORT: Edited by Paul E. Wischmeyer Source Type: research

Postoperative period
Publication date: Available online 17 March 2018 Source:Anaesthesia Critical Care & Pain Medicine Author(s): Working party approved by the French Society of Anaesthesia and Intensive Care Medicine (SFAR) the French Society for the study of Diabetes (SFD)GaëlleCheissonSophieJacqueminetEmmanuelCossonCaroleIchaiAnne-MarieLeguerrierBogdanNicolescu-CatargiAlexandreOuattaraIgorTauveronPaulValensiDanBenhamouCorresponding author. In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) level...
Source: Anaesthesia, Critical Care and Pain Medicine - April 18, 2018 Category: Anesthesiology Source Type: research

Perioperative management of adult diabetic patients. Preoperative period
Publication date: June 2018 Source:Anaesthesia Critical Care & Pain Medicine, Volume 37, Supplement 1 Author(s): Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) levels, and to adjust any treatments accordingly before surgery, paying particular attention to specific complications of diabetes. Gastrop...
Source: Anaesthesia, Critical Care and Pain Medicine - June 19, 2018 Category: Anesthesiology Source Type: research

Glycemic Trajectories After Tuberculosis Diagnosis and Treatment Outcomes of New Tuberculosis Patients: A Prospective Study in Eastern China
Conclusions Among tuberculosis patients without diabetes, glycemic changes were common and may represent an important marker for patient response to tuberculosis treatment.PMID:33705666 | DOI:10.1164/rccm.202007-2634OC
Source: American Journal of Respiratory and Critical Care Medicine - March 11, 2021 Category: Respiratory Medicine Authors: Qiao Liu Nannan You Hongqui Pan Ye Shen Peng Lu Jianming Wang Wei Lu Limei Zhu Leonardo Martinez Source Type: research

Metformin: Experimental and Clinical Evidence for a Potential Role in Emphysema Treatment
CONCLUSIONS: Metformin protected against CS-induced lung, renal, and muscle injury, mitochondrial dysfunction, and UPR-ER stress in mice. In humans, metformin use was associated with lesser emphysema progression over time. Our results provide a rationale for clinical trials testing the efficacy of metformin in limiting emphysema progression and its systemic consequences.PMID:34033525 | DOI:10.1164/rccm.202012-4510OC
Source: American Journal of Respiratory and Critical Care Medicine - May 25, 2021 Category: Respiratory Medicine Authors: Francesca Polverino Tianshi David Wu Joselyn Rojas-Quintero Xiaoyun Wang Jonathan Mayo Michael Tomchaney Judy Tram Samuel Packard Duo Zhang Kristan H Cleveland Elizabeth Cordoba-Lanus Caroline A Owen Ashraf Fawzy Greg L Kinney Craig P Hersh Nadia N Hansel Source Type: research

Can Metformin Downshift the Gears of Aging to Slow Emphysema Progression?
Am J Respir Crit Care Med. 2021 Jun 30. doi: 10.1164/rccm.202105-1273ED. Online ahead of print.NO ABSTRACTPMID:34191690 | DOI:10.1164/rccm.202105-1273ED
Source: American Journal of Respiratory and Critical Care Medicine - June 30, 2021 Category: Respiratory Medicine Authors: Irina Petrache Karina A Serban Source Type: research