De Decker Koen, Cordonnier Jan, Jacobs Werner, Coucke Vera, Schepens Paul, Jorens Philippe G
Department of Critical Care Medicine, University Hospital of Antwerp, Edegem, Belgium.
Forensic Sci Int. 2008 Feb 25;175(1):79-82. doi: 10.1016/j.forsciint.2007.07.010. Epub 2007 Sep 17.
Poisoning may also lead to both coma and multiple organ failure, also in youngsters without a known major medical history. As not all toxic agents are routinely screened when a poisoning is suspected, it is useful to consider less frequently encountered poisons in certain cases. We describe the occurrence of asystole and multiple organ failure which occurred in a young man after a suspected tramadol overdose. The tramadol concentration on admission in the ICU was indeed 8 microg/ml (mg/l), far above the therapeutic range. Subsequently, the patient developed severe acute liver failure, finally leading to death. Post-mortem toxicology did not reveal any other poison responsible for this unfavourable course as only very high serum and tissue tramadol and desmethyltramadol concentrations were found. Only a few fatal poisonings attributable to tramadol alone, as observed in our case, have been reported. An overview of these cases is presented.
中毒也可能导致昏迷和多器官功能衰竭，在没有已知重大病史的年轻人中也是如此。由于在怀疑中毒时并非所有有毒物质都会进行常规筛查，因此在某些情况下考虑较少见的毒物是有用的。我们描述了一名年轻男子在疑似过量服用曲马多后发生心搏停止和多器官功能衰竭的情况。该患者入住重症监护病房时曲马多浓度确实为8微克/毫升（毫克/升），远高于治疗范围。随后，患者出现严重急性肝衰竭，最终导致死亡。尸检毒理学未发现任何其他毒物导致这一不良病程，因为仅发现血清和组织中的曲马多及去甲基曲马多浓度非常高。如我们病例中所见，仅有少数单独由曲马多导致的致命中毒病例被报道。本文对这些病例进行了综述。
