Sein Anand Jacek, Barwina Małgorzata, Zajac Maciej, Kaletha Krystian
Department of Clinical Toxicology, Medical University of Gdańsk.
Przegl Lek. 2012;69(8):585-6.
We present a case of a 22-year-old male who, in a suicide attempt, ingested approximately 200 g of potassium chlorate. Upon admission to the hospital, he presented in full respiratory failure with cyanosis. Methylene blue antidote was given but found to be ineffective. The patient was intubated and mechanical ventilation was initiated. Because of renal failure with anuria, intermittent haemodialysis (iHD) followed by continuous venovenous hemodiafiltration (CVVHDF) was performed. His hospital stay was also complicated by hemolysis, disseminated intravascular coagulation, and atrial fibrillation. Transfusions of packed red blood cells, platelets, and fresh frozen plasma were necessary to correct the deficits. He also developed liver failure and required two sessions of molecular adsorbent recirculating system (MARS) therapy. On day 14 of his hospitalization, he regained consciousness, as well as full respiratory and circulatory function. There are no controlled studies addressing management of potassium chlorate poisoning. We suggest that early renal replacement therapy should be strongly considered.
我们报告一例22岁男性自杀未遂病例,其摄入了约200克氯酸钾。入院时,他出现了完全性呼吸衰竭并伴有发绀。给予亚甲蓝解毒剂,但发现无效。患者接受了气管插管并开始机械通气。由于肾衰竭伴无尿,先后进行了间歇性血液透析(iHD)和连续性静脉-静脉血液透析滤过(CVVHDF)。他的住院治疗还并发了溶血、弥散性血管内凝血和心房颤动。需要输注浓缩红细胞、血小板和新鲜冰冻血浆来纠正这些不足。他还出现了肝功能衰竭,需要进行两次分子吸附再循环系统(MARS)治疗。在住院第14天,他恢复了意识以及完全的呼吸和循环功能。目前尚无关于氯酸钾中毒治疗的对照研究。我们建议应强烈考虑早期肾脏替代治疗。