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<p>Both hyperlactataemia and metabolic acidosis are the subject of scientific research as predictive parameters for estimating neurological treatment outcomes after cardiopulmonary resuscitation. Lactate is considered a&#xa0;surrogate parameter for global hypoperfusion after cardiac arrest. We present the case of a&#xa0;patient with an initial pH of 6.45, a&#xa0;lactate concentration of 21 mmol/l and ketonemia after cardiopulmonary resuscitation, whose lactic acidosis was not primarily due to circulatory collapse but to metformin-associated metabolic imbalance. The patient survived 4 min of cardiopulmonary resuscitation and 45&#xa0;days in intensive care and hospitalisation with foot paresis as the only neurological deficit. In nonhypoxic lactic acidosis (type&#xa0;B), the prognostic significance of pH and lactate values must be interpreted with caution.</p>

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Erfolgreiche kardiopulmonale Reanimation bei metforminassoziierter Laktatazidose und Ketonämie mit initialem pH von 6,45

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月12日

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  • J. Knop,
  • F. Voß,
  • P. Kienbaum,
  • S. Roth,
  • H. Aubin,
  • M. Bernhard,
  • Mark Michael

摘要

Both hyperlactataemia and metabolic acidosis are the subject of scientific research as predictive parameters for estimating neurological treatment outcomes after cardiopulmonary resuscitation. Lactate is considered a surrogate parameter for global hypoperfusion after cardiac arrest. We present the case of a patient with an initial pH of 6.45, a lactate concentration of 21 mmol/l and ketonemia after cardiopulmonary resuscitation, whose lactic acidosis was not primarily due to circulatory collapse but to metformin-associated metabolic imbalance. The patient survived 4 min of cardiopulmonary resuscitation and 45 days in intensive care and hospitalisation with foot paresis as the only neurological deficit. In nonhypoxic lactic acidosis (type B), the prognostic significance of pH and lactate values must be interpreted with caution.