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  1. Article ; Online: Should dialysis be offered in all cases of metformin-associated lactic acidosis?

    Finkle, S Neil

    Critical care (London, England)

    2009  Volume 13, Issue 1, Page(s) 110

    Abstract: Metformin is commonly used in diabetes mellitus type 2, with lactic acidosis being a rare but potentially fatal complication of this therapy. The management of metformin-associated lactic acidosis (MALA) is controversial. Treatment may include supportive ...

    Abstract Metformin is commonly used in diabetes mellitus type 2, with lactic acidosis being a rare but potentially fatal complication of this therapy. The management of metformin-associated lactic acidosis (MALA) is controversial. Treatment may include supportive care, activated charcoal, bicarbonate infusion, hemodialysis, or continuous venovenous hemofiltration. In the previous issue of Critical Care, Peters and colleagues systematically evaluated outcomes in MALA patients admitted to their intensive care unit. The mortality rate of patients who received dialysis was similar to that of patients who were not dialyzed. However, it was the more acutely and chronically ill patients who actually received dialysis. This suggests that hemodialysis was beneficial in preventing a higher mortality rate in those who required renal replacement therapy.
    MeSH term(s) Acidosis, Lactic/chemically induced ; Acidosis, Lactic/therapy ; Animals ; Humans ; Metformin/adverse effects ; Renal Dialysis/methods
    Chemical Substances Metformin (9100L32L2N)
    Language English
    Publishing date 2009-01-09
    Publishing country England
    Document type Comment ; Journal Article ; Review
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/cc7161
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5517: Show issues Location:
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  2. Article ; Online: Predictors of Care Gaps in Home Dialysis: The Home Dialysis Virtual Ward Study.

    Nadeau-Fredette, Annie-Claire / Chan, Christopher T / Bargman, Joanne M / Copland, Michael A / Finkle, S Neil / Oliver, Matthew J / Pauly, Robert P / Perl, Jeffrey / Shah, Nikhil A / Zimmerman, Deborah L / Tennankore, Karthik K

    American journal of nephrology

    2019  Volume 50, Issue 5, Page(s) 392–400

    Abstract: Background: Home dialysis patients may be at an increased risk of adverse events after transitional states. The home dialysis virtual ward (HDVW) trial was conducted in Canadian dialysis centers and aimed to evaluate potential care gaps and patient ... ...

    Abstract Background: Home dialysis patients may be at an increased risk of adverse events after transitional states. The home dialysis virtual ward (HDVW) trial was conducted in Canadian dialysis centers and aimed to evaluate potential care gaps and patient satisfaction during the HDVW.
    Methods: The HDVW was a multicenter single-arm trial including peritoneal dialysis and home hemodialysis patients after 4 different events (hospital discharge, medical procedure, antibiotics, completion of training). Telephone-led interviews using a standardized assessment tool were performed over a 2-week period to assess a patient's care and adjust treatment as required. Upon completion, patients were surveyed to evaluate their perceived impact on domains of care using a rating scale; 1 not satisfied to 10 completely satisfied.
    Results: The HDVW trial included 193 patients with a median number of potential care gaps/interventions of 1 (0-2) per patient. Patients admitted to the HDVW after hospital discharge were at a higher risk of potential gaps in care (OR 2.16, 95% CI 1.29-3.62), while longer dialysis vintage was -associated with a lower number of gaps/interventions (OR 0.97 per year, 95% CI 0.95-0.98). A total of 105/193 (54%) patients completed satisfaction surveys. Patients were highly satisfied with the HDVW (median rating scale score 8, IQR 2) and felt it had a positive impact (rating scale score ≥7) on their overall health, understanding of treatment and access to a nephrologist.
    Conclusion: The HDVW was effective at identifying several potential care gaps, and patients were satisfied across several domains of care. This intervention may be valuable in supporting home dialysis patients during care transitions.
    MeSH term(s) Adult ; Aftercare/methods ; Aftercare/organization & administration ; Aftercare/statistics & numerical data ; Aged ; Canada ; Female ; Hemodialysis, Home/adverse effects ; Hemodialysis, Home/methods ; Humans ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Patient Education as Topic/methods ; Patient Education as Topic/organization & administration ; Patient Satisfaction ; Peritoneal Dialysis/adverse effects ; Peritoneal Dialysis/methods ; Professional Practice Gaps/statistics & numerical data ; Telephone ; Treatment Outcome
    Language English
    Publishing date 2019-10-10
    Publishing country Switzerland
    Document type Clinical Trial ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 604540-6
    ISSN 1421-9670 ; 0250-8095
    ISSN (online) 1421-9670
    ISSN 0250-8095
    DOI 10.1159/000503439
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1635: Show issues Location:
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  3. Article: Severe lactic acidosis treated with prolonged hemodialysis: recovery after massive overdoses of metformin.

    Guo, Peter Y F / Storsley, Leroy J / Finkle, S Neil

    Seminars in dialysis

    2006  Volume 19, Issue 1, Page(s) 80–83

    Abstract: We report two cases of severe lactic acidosis due to massive metformin ingestion. The first case was a 37-year-old man who was discovered several hours after ingesting 45 g of metformin. He had severe lactic acidosis (blood pH 6.81, bicarbonate 4 mEq/L, ... ...

    Abstract We report two cases of severe lactic acidosis due to massive metformin ingestion. The first case was a 37-year-old man who was discovered several hours after ingesting 45 g of metformin. He had severe lactic acidosis (blood pH 6.81, bicarbonate 4 mEq/L, lactate 25.7 mEq/L). Despite intravenous bicarbonate therapy, he decompensated and was placed on a combination of hemodialysis and charcoal hemoperfusion for a continuous time of 25 hours. His hospital course was complicated by acute renal failure requiring a period of intermittent hemodialysis. He has since made a complete recovery. The second case was a 53-year-old man who ingested 50 g of metformin. He also presented with severe lactic acidosis (blood pH 6.85, bicarbonate 3 mEq/L and lactate 28.4 mEq/L) and deteriorated despite intravenous bicarbonate therapy. He was placed on hemodialysis as a continuous therapy for 21 hours. His hospital course was complicated by acute renal failure requiring a period of intermittent hemodialysis. He has subsequently made a complete recovery. Metformin-associated lactic acidosis carries a high mortality rate. Prolonged hemodialysis should be considered as an early treatment option in these cases.
    MeSH term(s) Acidosis, Lactic/chemically induced ; Acidosis, Lactic/therapy ; Adult ; Drug Overdose ; Humans ; Hypoglycemic Agents/poisoning ; Male ; Metformin/poisoning ; Middle Aged ; Renal Dialysis ; Severity of Illness Index ; Time Factors
    Chemical Substances Hypoglycemic Agents ; Metformin (9100L32L2N)
    Language English
    Publishing date 2006-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1028193-9
    ISSN 1525-139X ; 0894-0959
    ISSN (online) 1525-139X
    ISSN 0894-0959
    DOI 10.1111/j.1525-139X.2006.00123.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2879: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  4. Article: Predictors of Care Gaps in Home Dialysis: The Home Dialysis Virtual Ward Study

    Nadeau-Fredette, Annie-Claire / Chan, Christopher T. / Bargman, Joanne M. / Copland, Michael A. / Finkle, S. Neil / Oliver, Matthew J. / Pauly, Robert P. / Perl, Jeffrey / Shah, Nikhil A. / Zimmerman, Deborah L. / Tennankore, Karthik K.

    American Journal of Nephrology

    2019  Volume 50, Issue 5, Page(s) 392–400

    Abstract: ... a standardized assessment tool were performed over a 2-week period to assess a patient’s care and adjust ...

    Institution Hopital Maisonneuve-Rosemont and Research Center, Montreal, Québec, Canada
    University Health Network/Toronto General Hospital, Toronto, Ontario, Canada
    University of British Columbia, Vancouver, British Columbia, Canada
    Dalhousie University/Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
    Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
    University of Alberta, Edmonton, Alberta, Canada
    St. Michael’s Hospital, Toronto, Ontario, Canada
    The Ottawa Hospital, Ottawa, Ontario, Canada
    Abstract Background: Home dialysis patients may be at an increased risk of adverse events after transitional states. The home dialysis virtual ward (HDVW) trial was conducted in Canadian dialysis centers and aimed to evaluate potential care gaps and patient satisfaction during the HDVW. Methods: The HDVW was a multicenter single-arm trial including peritoneal dialysis and home hemodialysis patients after 4 different events (hospital discharge, medical procedure, antibiotics, completion of training). Telephone-led interviews using a standardized assessment tool were performed over a 2-week period to assess a patient’s care and adjust treatment as required. Upon completion, patients were surveyed to evaluate their perceived impact on domains of care using a rating scale; 1 not satisfied to 10 completely satisfied. Results: The HDVW trial included 193 patients with a median number of potential care gaps/interventions of 1 (0–2) per patient. Patients admitted to the HDVW after hospital discharge were at a higher risk of potential gaps in care (OR 2.16, 95% CI 1.29–3.62), while longer dialysis vintage was ­associated with a lower number of gaps/interventions (OR 0.97 per year, 95% CI 0.95–0.98). A total of 105/193 (54%) patients completed satisfaction surveys. Patients were highly satisfied with the HDVW (median rating scale score 8, IQR 2) and felt it had a positive impact (rating scale score ≥7) on their overall health, understanding of treatment and access to a nephrologist. Conclusion: The HDVW was effective at identifying several potential care gaps, and patients were satisfied across several domains of care. This intervention may be valuable in supporting home dialysis patients during care transitions.
    Keywords Home dialysis ; Home hemodialysis ; Peritoneal dialysis ; Hospitalization ; Virtual ward ; Telemedicine ; Transition
    Language English
    Publishing date 2019-10-10
    Publisher S. Karger AG
    Publishing place Basel, Switzerland
    Document type Article
    Note Patient-Oriented, Translational Research: Research Article
    ZDB-ID 604540-6
    ISSN 1421-9670 ; 0250-8095
    ISSN (online) 1421-9670
    ISSN 0250-8095
    DOI 10.1159/000503439
    Database Karger publisher's database

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1635: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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