IBCC chapter & cast: Metformin-induced lactic acidosis, et al.

Metformin poisoning and lactic acidosis has always been murky.  For years there was debate about whether metformin-induced lactic acidosis exists (short answer:  it obviously does).  However, for an individual patient, it can still be confusing sorting out the contribution of metformin to their critical illness.  A recent re-definition of the condition clarifies things a bit, but substantial confusion persists regarding how to diagnose and treat these patients.