{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T18:32:13Z","timestamp":1767983533619,"version":"3.49.0"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Lactic acidosis is a serious metabolic disorder characterized by an accumulation of lactate in the body, which can lead to a severe acid-base imbalance. Metformin-associated lactic acidosis is a rare but life-threatening complication of metformin therapy, particularly in the setting of acute kidney injury or other conditions that impair lactate clearance. In this case report, we present the remarkable survival of a patient who experienced severe metformin-associated lactic acidosis with a blood pH of 6.8 and a lactate level of 29 mmol\/L, which are typically considered incompatible with life.<\/jats:p>","DOI":"10.3389\/fmed.2025.1604360","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T05:31:49Z","timestamp":1760592709000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Dancing with death at pH 6.8 and lactate of 29 mmol\/L: extreme survival in severe metformin-associated lactic acidosis - a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Said","family":"Kortli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Amathieu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Ghalayini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1111\/dme.12017","article-title":"The criteria for metformin-associated lactic acidosis: the quality of reporting in a large pharmacovigilance database.","volume":"30","author":"Kajbaf","year":"2013","journal-title":"Diabetic Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"99-110","DOI":"10.1016\/s0002-9343(96)00353-1","article-title":"An overview of metformin in the treatment of type 2 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