• BMJ case reports · Jan 2015

    Case Reports

    A severe case of vasoplegic shock following metformin overdose successfully treated with methylene blue as a last line therapy.

    • Rachel Erin Graham, Michaela Cartner, and James Winearls.
    • Intensive Care Unit, Gold Coast University Hospital, Southport, Queensland, Australia.
    • BMJ Case Rep. 2015 Jan 1; 2015.

    AbstractA 44-year-old man presented to hospital 24 h after an intentional overdose of metformin and gliclazide. He had a critical metabolic acidosis on presentation with a pH of 6.88, and very rapidly deteriorated into distributive shock refractory to large volume fluid resuscitation and massive doses of vasopressors. We introduced a methylene blue infusion as a rescue therapy in an attempt to improve the patient's haemodynamics, which was successful. The patient made a full recovery with no long-term sequelae.2015 BMJ Publishing Group Ltd.

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