a review on the protective effects of metformin in sepsis-induced organ failure

Despite advances in sepsis management, it remains a major intensive-care-unit (icu) concern. from new prospective, positive effects of metformin, such as anti-oxidant and anti-inflammatory properties are considered potentially beneficial properties for management of septic patients. this article reviewed the potential ameliorative effects of metformin in sepsis-induced organ failure. information were retrieved from pubmed, scopus, embase, and google scholar. multi-organ damage, oxidative stress, inflammatory cytokine stimulation, and altered circulation are hallmarks of sepsis. metformin exerts its effect via adenosine monophosphate-activated protein kinase (ampk) activation. it improves sepsis-induced organ failure by inhibiting the production of reactive oxygen species (ros) and pro-inflammatory cytokines, preventing the activation of transcription factors related to inflammation, decreasing neutrophil accumulation/infiltration, and also maintaining mitochondrial membrane potential. studies reported the safety of metformin therapeutic doses, with no evidence of lactic acidosis, in septic patients.