Effect of metformin on survival rate in experimental sepsis

Gras, Valérie; Bouffandeau, B; Montravers, P.; Lalau, Jean–Daniel

doi:10.1016/s1262-3636(07)70261-6

Cited by 27 publications

(16 citation statements)

References 16 publications

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“…septic murine model have shown that even at doses mimicking accumulation, metformin did not increase mortality and may even be protective (13). Furthermore, in the clinical setting, lactate and metformin levels do not correlate with the mortality rate, suggesting that additional factors play a substantial role in the outcome (4,11).…”

Section: Discussionmentioning

confidence: 99%

Metformin-associated lactic acidosis: A prognostic and therapeutic study*

Seidowsky

Nseir

Houdret

et al. 2009

Critical Care Medicine

179

130

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Section: Discussionmentioning

confidence: 99%

Metformin-associated lactic acidosis: A prognostic and therapeutic study*

Seidowsky

Nseir

Houdret

et al. 2009

Critical Care Medicine

179

130

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“…Furthermore, it has been hypothesized that metformin, possibly through its beneficial effects on vasomotility, might even be protective in shock [26,29]. …”

Section: Discussionmentioning

confidence: 99%

Outcome of severe lactic acidosis associated with metformin accumulation

et al. 2010

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IntroductionMetformin associated lactic acidosis (MALA) may complicate metformin therapy, particularly if metformin accumulates due to renal dysfunction. Profound lactic acidosis (LA) generally predicts poor outcome. We aimed to determine if MALA differs in outcome from LA of other origin (LAOO).MethodsWe conducted a retrospective analysis of all patients admitted with LA to our medical ICU of a tertiary referral center during a 5-year period. MALA patients and LAOO patients were compared with respect to parameters of acid-base balance, serum creatinine, hospital outcome, Simplified Acute Physiology Score II (SAPS II) and Sequential Organ Failure Assessment (SOFA) score, using Pearson's Chi-square or the Mann-Whitney U-test.ResultsOf 197 patients admitted with LA, 10 had been diagnosed with MALA. With MALA, median arterial blood pH was significantly lower (6.78 [range 6.5 to 6.94]) and serum lactate significantly higher (18.7 ± 5.3 mmol/L) than with LAOO (pH 7.20 [range 6.46 to 7.35], mean serum lactate 11.2 ± 6.1 mmol/L). Overall mortality, however, was comparable (MALA 50%, LAOO 74%). Furthermore, survival of patients with arterial blood pH < 7.00 (N = 41) was significantly better (50% vs. 0%) if MALA (N = 10) was the underlying condition compared to LAOO (N = 31).ConclusionsCompared to similarly severe lactic acidosis of other origin, the prognosis of MALA is significantly better. MALA should be considered in metformin-treated patients presenting with lactic acidosis.

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“…160 In contrast, experimental sepsis following intraperitoneal administration of the same dose of a pathogenic strain of E. coli was lethal to mice at 2 days after inoculation. 167 Oral administration of probiotics appeared to be by far the safest route and outlined the very low infectivity of LAB and absence of safety issues for current uses in healthy populations.…”

Section: Measurement Of Safety: Limitations Of Existing Modelsmentioning

confidence: 99%

Safety assessment of probiotics for human use

et al. 2010

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The safety of probiotics is tied to their intended use, which includes consideration of potential vulnerability of the consumer or patient, dose and duration of consumption, and both the manner and frequency of administration. Unique to probiotics is that they are alive when administered, and unlike other food or drug ingredients, possess the potential for infectivity or in situ toxin production. Since numerous types of microbes are used as probiotics, safety is also intricately tied to the nature of the specific microbe being used. The presence of transferable antibiotic resistance genes, which comprises a theoretical risk of transfer to a less innocuous member of the gut microbial community, must also be considered. Genetic stability of the probiotic over time, deleterious metabolic activities, and the potential for pathogenicity or toxicogenicity must be assessed depending on the characteristics of the genus and species of the microbe being used. Immunological effects must be considered, especially in certain vulnerable populations, including infants with undeveloped immune function. A few reports about negative probiotic effects have surfaced, the significance of which would be better understood with more complete understanding of the mechanisms of probiotic interaction with the host and colonizing microbes. Use of readily available and low cost genomic sequencing technologies to assure the absence of genes of concern is advisable for candidate probiotic strains. The field of probiotic safety is characterized by the scarcity of studies specifically designed to assess safety contrasted with the long history of safe use of many of these microbes in foods.

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Effect of metformin on survival rate in experimental sepsis

Cited by 27 publications

References 16 publications

Metformin-associated lactic acidosis: A prognostic and therapeutic study*

Metformin-associated lactic acidosis: A prognostic and therapeutic study*

Outcome of severe lactic acidosis associated with metformin accumulation

Safety assessment of probiotics for human use

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