Bourdeaux Chris, Bewley Jeremy
Department of Anaesthesia, Bristol Royal Infirmary, Bristol, UK.
Emerg Med J. 2007 May;24(5):e31. doi: 10.1136/emj.2006.043216.
A case of death from severe paracetamol poisoning which presented early and received appropriate treatment according to evidence-based guidelines is presented here. It is very rare for patients to die from paracetamol poisoning when they receive N-acetylcysteine (NAC) within 8 h of ingestion. The patient had a marked lactic acidosis on presentation to hospital. This case demonstrates that a patient can die from paracetamol poisoning despite early and appropriate treatment, and raises the question whether lactic acidosis in a patient following paracetamol overdose should prompt the initiation of NAC treatment while awaiting paracetamol levels.
本文介绍了一例因严重扑热息痛中毒死亡的病例，该病例早期就诊并根据循证指南接受了适当治疗。摄入扑热息痛后8小时内接受N - 乙酰半胱氨酸（NAC）治疗的患者死于扑热息痛中毒的情况非常罕见。该患者入院时存在明显的乳酸酸中毒。此病例表明，尽管进行了早期且适当的治疗，患者仍可能死于扑热息痛中毒，并引发了一个问题，即扑热息痛过量患者出现乳酸酸中毒时，在等待扑热息痛血药浓度结果期间是否应启动NAC治疗。
