Table 3. Review of post-operative MALA cases.
| Cases | Comorbidity | Therapy | MALA onset from surgery/type of surgery | Treatment (type and time from ED admission) | ICU stay | Outcome | Preoperative metformin last administration |
|---|---|---|---|---|---|---|---|
| Case 1, female, 74-year-old | Diabetes type 2, hypertension, dyslipidemia, hyperuricemia | Metformin 2,500 mg, perindopril tert-butylamine 8 mg, doxazosin 2 mg, atorvastatin 20 mg, allopurinol 300 mg |
12 days/abdominal adenolysis | CVVHD-CiCa, supportive care, vasopressor, mild sedation, sodio bicarbonate infusion, 5 hours | 96 hours | Alive | 48 hours |
| Case 2, male, 78-year-old | Diabetes type II, ischemic heart disease, paroxysmal atrial fibrillation |
Metformin 1,000 mg, lansoprazole 15 mg, folic acid 5 mg, amiodarone 200 mg, clopidogrel 75 mg, aspirin 100 mg, rosuvastatin 20 mg, amlodipine 10 mg |
15 days/right hemicolectomy | CVVHD-CiCa, supportive care, vasopressor, mild sedation, sodio bicarbonate infusion, 7 hours | 48 hours | Alive | 48 hours |
| Mears et al. (10), male, 82-year-old | Diabetes type II, hypothyroidism, benign prostatic hypertrophy |
Metformin 500 mg, levothyroxine 0.1 mg | 36 hours/cervical decompression | Supportive care | 96 hours | Alive | 24 hours |
| Gonçalves et al. (11), female, 65-year-old | Diabetes type II, diabetic retinopathy, chronic kidney disease, dyslipidemia, hypertension, hyperuricemia, anemia, peripheral venous insufficiency | Metformin 500 mg, levothyroxine 0.1 mg | 37 hours/cervical decompression | Supportive care | 97 hours | Alive | 12 hours |
| Margiani et al. (12), male, 70-year-old | Diabetes type II, benign prostatic hypertrophy, hypertension |
Metformin 3,000 mg, irbesartan/hydrochlorothiazide 150 mg/12.5 mg, tamsulosin 0.4 mg |
14 days/low anterior rectal resection with ileostomy |
CVVHD-CiCa, supportive care | 8 days | Alive | 72 hours |
| Mercker et al. (13), male, 66-year-old | Diabetes type II, hypertension, peripheral vascular disease, previous pulmonary embolism | Metformin 500 mg, nifedipine, isosorbide mononitrate, phenprocoumon |
96 hours/abdominal hernia repair | Supportive care, 2 hours |
49 days | Dead | 24 hours |
| Cotae et al. (14), female, 90-year-old | Diabetes type II, hypertension, atrial fibrillation | Metformin, sitagliptin, gliquidone | 72 hours/left hip hemiarthroplasty and great trochanter osteosynthesis | CVVHD-CiCa, supportive care | – | Alive | – |
MALA, metformin-associated lactic acidosis; ED, emergency department; ICU, intensive care unit; CVVHD-CiCa, continuous veno-venous hemodialysis with citrate and calcium.