A Review on The Protective Effects of Metformin in SepsisInduced Organ Failure

Despite advances in sepsis management, it remains a major intensivecareunit (ICU) concern. From new prospective, positive effects of metformin, such as antioxidant and antiinflammatory properties are considered potentially beneficial properties for management of septic patients. This article reviewed the potential ameliorative effects of metformin in sepsisinduced organ failure. Information were retrieved from PubMed, Scopus, Embase, and Google Scholar. Multiorgan damage, oxidative stress, inflammatory cytokine stimulation, and altered circulation are hallmarks of sepsis. Metformin exerts its effect via adenosine monophosphateactivated protein kinase (AMPK) activation. It improves sepsisinduced organ failure by inhibiting the production of reactive oxygen species (ROS) and proinflammatory 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.