Shenoi Asha N, Gertz Shira J, Mikkilineni Sushmita, Kalyanaraman Meena
Department of Pediatrics, Children's Hospital of New Jersey, Newark, NJ 07112, USA.
Pediatr Emerg Care. 2011 Jan;27(1):43-5. doi: 10.1097/PEC.0b013e3182045f76.
An 11-month-old male infant presented with history of bupropion ingestion (750 mg/kg). He developed seizures, respiratory failure, and severe hypotension with metabolic acidosis refractory to inotropic support. The patient received mechanical ventilation, intralipids, phenytoin, inotropic support (dopamine, norepinephrine, and epinephrine), and extracorporeal membrane oxygenation (ECMO). Inotropes were weaned upon initiation of ECMO and discontinued 66 hours after ingestion. Total ECMO duration was 71 hours. The patient was extubated on hospital day 8 and has not had any neurological sequelae upon 12-month follow-up examinations. We report for the first time successful use of ECMO after ingestion of a potentially fatal dose of bupropion.
一名11个月大的男婴因摄入安非他酮（750毫克/千克）前来就诊。他出现了癫痫发作、呼吸衰竭以及严重低血压，并伴有对血管活性药物支持无效的代谢性酸中毒。该患者接受了机械通气、静脉输注脂肪乳、苯妥英钠、血管活性药物支持（多巴胺、去甲肾上腺素和肾上腺素）以及体外膜肺氧合（ECMO）治疗。在启动ECMO后逐渐停用血管活性药物，并在摄入药物66小时后停药。ECMO总时长为71小时。患者于住院第8天拔管，在12个月的随访检查中未出现任何神经后遗症。我们首次报告了在摄入可能致命剂量的安非他酮后成功使用ECMO的病例。
