Sharma Deepak S, Ahmed Ahmed, Razak Ali A, Sharma Priyanka
Critical Care Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, GBR.
Anesthesia and Critical Care Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, GBR.
Cureus. 2023 Feb 8;15(2):e34761. doi: 10.7759/cureus.34761. eCollection 2023 Feb.
Lactate is the basic blood parameter in the arsenal of an intensivist when managing a critically ill patient. A 62-year-old male presented with nausea and vomiting. He had been using an Ayurvedic medication, Insulin Management Expert (IME-9), for his type 2 diabetes mellitus and was found to have severe lactic acidosis that was resistant to initial fluid resuscitation and Ayurvedic medicine-induced liver injury. He required admission to critical care for organ support and ultimately recovered. Because current literature on the adverse effects of this Ayurvedic medication, particularly hepatotoxicity, is limited, causality was determined using the adverse drug association tool Roussel Uclaf Causality Assessment Method (RUCAM), which determined this as a probable cause with a strong score of seven. As a result, our case adds a vital gear to the wheel of current research literature.
乳酸是重症监护医生在管理重症患者时常用的基本血液参数。一名62岁男性出现恶心和呕吐症状。他一直在使用一种阿育吠陀药物——胰岛素管理专家（IME - 9）来治疗2型糖尿病，结果被发现患有严重的乳酸酸中毒，对初始液体复苏和阿育吠陀药物引起的肝损伤均有抵抗。他需要入住重症监护病房接受器官支持，最终康复。由于目前关于这种阿育吠陀药物不良反应，尤其是肝毒性的文献有限，因此使用药物不良反应关联工具——鲁塞尔·优克福因果关系评估方法（RUCAM）来确定因果关系，该工具将此判定为可能原因，得分为7分，属于高分。因此，我们的病例为当前研究文献增添了重要内容。
