Chan Cheng-Wei, Wu I-Lin, Lee Ching-Hsing, Hsu Shou-Chien, Liao Shu-Chen
1Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan.2College of Medicine, Chang Gung University, Taoyuan, Taiwan.3Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.4Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Crit Care Med. 2016 Jan;44(1):e45-7. doi: 10.1097/CCM.0000000000001352.
To describe the experience of emergency extracorporeal membrane oxygenation in treating life-threatening glyphosate-surfactant intoxication.
Case report.
Emergency department and ICU.
A patient with cardiopulmonary failure after glyphosate-surfactant intoxication.
Extracorporeal membrane oxygenation.
A 47-year-old man presented with mildly decreased consciousness in our emergency department after ingesting approximately 100 mL of glyphosate-surfactant 1.5 hours previously. Respiratory failure, persistent ventricular tachycardia, profound shock refractory to inotropic agents, and metabolic acidosis developed in the patient within 2 hours. Extracorporeal membrane oxygenation was applied within 4 hours of cardiopulmonary failure. The patient's condition improved considerably. He was transferred to the general ward on the eighth day with stable hemodynamic status and complete neurological recovery.
On the basis of our research, this was the first case in which extracorporeal membrane oxygenation was used to treat severe glyphosate-surfactant intoxication. We recommend early initiation of extracorporeal membrane oxygenation therapy to mitigate cardiopulmonary compromise in patients with glyphosate-surfactant intoxication.
描述急诊体外膜肺氧合治疗危及生命的草甘膦 - 表面活性剂中毒的经验。
病例报告。
急诊科和重症监护病房。
一名草甘膦 - 表面活性剂中毒后出现心肺衰竭的患者。
体外膜肺氧合。
一名47岁男性在1.5小时前摄入约100毫升草甘膦 - 表面活性剂后，在我院急诊科出现轻度意识减退。患者在2小时内出现呼吸衰竭、持续性室性心动过速、对血管活性药物难治的严重休克以及代谢性酸中毒。在心肺衰竭4小时内应用了体外膜肺氧合。患者病情显著改善。第8天，他被转入普通病房，血流动力学稳定，神经功能完全恢复。
基于我们的研究，这是首例使用体外膜肺氧合治疗严重草甘膦 - 表面活性剂中毒的病例。我们建议早期启动体外膜肺氧合治疗，以减轻草甘膦 - 表面活性剂中毒患者的心肺功能损害。
