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急性肾衰竭并发一氧化碳中毒

Acute kidney failure complicating carbon monoxide poisoning.

作者信息

Kade Grzegorz, Osman Agnieszka, Antosiewicz Stefan, Wańkowicz Zofia

机构信息

Klinika Chorób Wewnętrznych, Nefrologii i Dializoterapii, Wojskowy Instytut Medyczny w Warszawie.

出版信息

Anaesthesiol Intensive Ther. 2012 Aug 8;44(2):89-91.

Abstract

BACKGROUND

Carbon monoxide, albeit common, is rarely associated with renal failure. We report a case of CO-associated kidney failure requiring short-term dialysis.

CASE REPORT

A 33 year-old male was found unconscious in a bathroom equipped with a propane-gas heater. The duration of exposure to carbon monoxide was unknown. The patient was transported to a regional hyperbaric centre;the carboxyhaemoglobin concentration in the blood on admission was 38.3%. After 60 min of exposure to hyperbaric oxygen, he regained consciousness and was transferred to the toxicology department. Mild rhabdomyolysis with acute kidney failure was diagnosed and despite two subsequent hyperbaric sessions, haemodialysis was necessary.The kidney failure resolved within two weeks, and the patient made a full recovery.Discussion and conclusions. Carbon monoxide mainly affects the central nervous system and the myocardium;renal failure may occur due to rhabdomyolysis and hypoxia. Therefore, all CO-poisoned patients should be closely monitored for their renal function.

摘要

背景

一氧化碳虽常见,但很少与肾衰竭相关。我们报告一例需要短期透析的一氧化碳相关性肾衰竭病例。

病例报告

一名33岁男性在一间装有丙烷燃气加热器的浴室中被发现昏迷。一氧化碳暴露时长未知。患者被转运至区域高压氧治疗中心;入院时血液中碳氧血红蛋白浓度为38.3%。经过60分钟的高压氧暴露后,他恢复了意识,并被转至毒理学科室。诊断为轻度横纹肌溶解合并急性肾衰竭,尽管随后又进行了两次高压氧治疗,但仍需要进行血液透析。肾衰竭在两周内得到缓解,患者完全康复。讨论与结论。一氧化碳主要影响中枢神经系统和心肌;肾衰竭可能因横纹肌溶解和缺氧而发生。因此,所有一氧化碳中毒患者都应密切监测其肾功能。

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