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单独使用甲吡唑治疗婴儿严重乙二醇中毒

Fomepizole alone for severe infant ethylene glycol poisoning.

作者信息

Detaille Thierry, Wallemacq Pierre, Clément de Cléty Stephan, Vanbinst Roger, Dembour Guy, Hantson Philippe

机构信息

Pediatric Intensive Care Unit, St-Luc Hospital, Université catholique de Louvain, Brussels, Belgium.

出版信息

Pediatr Crit Care Med. 2004 Sep;5(5):490-1. doi: 10.1097/01.PCC.0000128600.17670.FF.

DOI:10.1097/01.PCC.0000128600.17670.FF
PMID:15329167
Abstract

OBJECTIVE

To report a case of a massive ingestion of ethylene glycol in an infant successfully treated by fomepizole without hemodialysis.

DESIGN

Descriptive case report.

SETTING

Pediatric intensive care unit.

PATIENT

A 5-mo-old boy who ingested 200 mL of an antifreeze solution.

INTERVENTIONS

Antidotal therapy with a total of seven doses of fomepizole administered intravenously with an interval of 12 hrs (15 mg/kg as loading dose, then 10 mg/kg). Hemodialysis was not performed.

MEASUREMENTS AND MAIN RESULTS

Iterative determination of ethylene glycol concentration was obtained in blood and urine. Kinetics were calculated for ethylene glycol and fomepizole elimination. The infant made a complete recovery with no change in renal function.

CONCLUSIONS

Although not yet approved for this indication in the child, fomepizole seemed safe and effective in a case of severe ethylene glycol poisoning, without the need for hemodialysis.

摘要

目的

报告一例婴儿大量摄入乙二醇后成功使用甲吡唑治疗且未进行血液透析的病例。

设计

描述性病例报告。

地点

儿科重症监护病房。

患者

一名5个月大的男婴,摄入了200毫升防冻液溶液。

干预措施

总共静脉注射七剂甲吡唑进行解毒治疗,间隔12小时(负荷剂量为15毫克/千克,然后为10毫克/千克)。未进行血液透析。

测量指标及主要结果

对血液和尿液中的乙二醇浓度进行反复测定。计算了乙二醇和甲吡唑的消除动力学。婴儿完全康复,肾功能无变化。

结论

尽管甲吡唑尚未获批用于儿童的这一适应症,但在严重乙二醇中毒的病例中,它似乎安全有效,无需进行血液透析。

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引用本文的文献

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Extracorporeal treatment for ethylene glycol poisoning: systematic review and recommendations from the EXTRIP workgroup.体外治疗乙二醇中毒:来自 EXTRIP 工作组的系统评价和建议。
Crit Care. 2023 Feb 10;27(1):56. doi: 10.1186/s13054-022-04227-2.
2
Treatment of patients with ethylene glycol or methanol poisoning: focus on fomepizole.乙二醇或甲醇中毒患者的治疗:聚焦于甲吡唑
Open Access Emerg Med. 2010 Aug 24;2:67-75. doi: 10.2147/OAEM.S5346. eCollection 2010.
3
Massive ethylene glycol ingestion treated with fomepizole alone-a viable therapeutic option.
单独使用甲吡唑治疗大量乙二醇摄入——一种可行的治疗选择。
J Med Toxicol. 2010 Jun;6(2):131-4. doi: 10.1007/s13181-010-0061-2.
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Fomepizole as a therapeutic strategy in paediatric methanol poisoning. A case report and review of the literature.甲吡唑作为小儿甲醇中毒的治疗策略。一例病例报告及文献综述。
Eur J Pediatr. 2005 Mar;164(3):158-61. doi: 10.1007/s00431-004-1588-5. Epub 2004 Dec 1.