[Metformin treatment causes persisting lactic acidosis after cardiac arrest]

Metformin associated lactic acidosis (MALA) is a rare condition with a prevalence of 3 per 100,000 patient-years. The reported mortality is about 50%. We describe a case of MALA in a 61-year-old obese, type II diabetic male who suffered a sudden cardiac arrest. After resuscitation, the patient developed severe lactic acidosis requiring continuous renal replacement therapy. The patient died within seven days from multiorgan failure. MALA should be suspected in therapy-resistant lactic acidosis. Haemofiltration/haemodialysis will correct acidosis and clear metformin.