Ueno Masahito, Oda Jun, Soeda Hiroshi, Uesugi Hirotaka, Ueno Keiko, Fujise Yo, Yukioka Tetsuo
Department of Emergency and Critical Care Medicine Tokyo Medical University Shinjuku Tokyo Japan.
Department of Pharmacy Tokyo Medical University Shinjuku Tokyo Japan.
Acute Med Surg. 2014 Aug 8;2(2):120-122. doi: 10.1002/ams2.68. eCollection 2015 Apr.
A woman aged in her 20s ingested approximately 99 g acetylsalicylic acid, and was transported to our hospital 2 h later. She was lucid, but complained of hearing loss and tinnitus. We performed gastric lavage and gave her activated charcoal several times. We attempted to maintain the urinary pH at 7.5 and output above 100 mL/h while preparing for urgent hemodialysis.
It was revealed after discharge that the blood concentration of acetylsalicylic acid was 103.8 mg/dL on admission (lethal dose level) and had decreased to 35.4 mg/dL by the next morning. The half-life was 8.5 h.
Hemodialysis is strongly recommended for patients who take a lethal dose of acetylsalicylic acid. However, by carefully evaluating the vital signs and urinary output and pH, while preparing for emergency hemodialysis, we consider that it is possible to treat acetylsalicylic acid poisoning by alkaline diuresis and critical supportive care.
一名20多岁的女性摄入了约99克乙酰水杨酸，两小时后被送往我院。她神志清醒，但抱怨听力丧失和耳鸣。我们进行了洗胃，并多次给予她活性炭。在准备紧急血液透析的同时，我们试图将尿液pH值维持在7.5，尿量维持在每小时100毫升以上。
出院后发现，入院时乙酰水杨酸的血药浓度为103.8毫克/分升（致死剂量水平），到第二天早上已降至35.4毫克/分升。半衰期为8.5小时。
对于摄入致死剂量乙酰水杨酸的患者，强烈建议进行血液透析。然而，通过仔细评估生命体征、尿量和pH值，同时准备紧急血液透析，我们认为通过碱性利尿和重症支持治疗可以治疗乙酰水杨酸中毒。
