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成功救治磷化铝中毒致心脏骤停

Successful Management of Aluminium Phosphide Poisoning Resulting in Cardiac Arrest.

作者信息

Hakimoğlu Sedat, Dikey İsmail, Sarı Ali, Kekeç Leyla, Tuzcu Kasım, Karcıoğlu Murat

机构信息

Department of Anaesthesiology and Reanimation, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2015 Aug;43(4):288-90. doi: 10.5152/TJAR.2015.75010. Epub 2015 Mar 3.

Abstract

Aluminum phosphide has high toxicity when it is ingested, and in case of contact with moisture, phosphine gas is released. Aluminum phosphide poisoning causes metabolic acidosis, arrhythmia, acute respiratory distress syndrome and shock, and there is no specific antidote. A 17-year-old male patient was referred to our hospital because of aluminum phosphide poisoning with 1500 mg of aluminum phosphide tablets. The patient's consciousness was clear but he was somnolent. Vital parameters were as follows: blood pressure: 85/56 mmHg, pulse: 88 beats/min, SpO2: 94%, temperature: 36.4°C. Because of hypotension, noradrenaline and dopamine infusions were started. The patient was intubated because of respiratory distress and loss of consciousness. Severe metabolic acidosis was determined in the arterial blood gas, and metabolic acidosis was corrected by sodium bicarbonate treatment. In addition to supportive therapy of the poisoning, haemodialysis was performed. Cardiac arrest occurred during follow-ups in the intensive care unit, and sinus rhythm was achieved after 10 min of cardiopulmonary resuscitation. The patient was discharged after three sessions of haemodialysis on the ninth day. As a result, haemodialysis contributed to symptomatic treatment of aluminum phosphide poisoning in this case report.

摘要

磷化铝摄入后具有高毒性,接触水分时会释放出磷化氢气体。磷化铝中毒会导致代谢性酸中毒、心律失常、急性呼吸窘迫综合征和休克,且没有特效解毒剂。一名17岁男性患者因摄入1500毫克磷化铝片剂导致磷化铝中毒被转诊至我院。患者意识清醒但嗜睡。生命体征如下:血压:85/56 mmHg,脉搏:88次/分钟,血氧饱和度:94%,体温:36.4°C。由于低血压,开始输注去甲肾上腺素和多巴胺。患者因呼吸窘迫和意识丧失而行气管插管。动脉血气分析确定存在严重代谢性酸中毒,通过碳酸氢钠治疗纠正代谢性酸中毒。除了对中毒进行支持治疗外,还进行了血液透析。在重症监护病房随访期间发生心脏骤停,心肺复苏10分钟后恢复窦性心律。第九天在进行了三次血液透析后患者出院。因此,在本病例报告中血液透析有助于磷化铝中毒的对症治疗。

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