Wang Danqiong, Zhang Guozheng, Zhang Weiwen, Luo Jian, Zhu Lihua, Hu Jianhua
Department of Critical Care Medicine, Quzhou People's Hospital, Quzhou.
Zhejiang Chinese Medical University, Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China.
Medicine (Baltimore). 2019 Feb;98(6):e14414. doi: 10.1097/MD.0000000000014414.
Because of the lack of an antidote or effective treatment, patients with severe acute diquat and glyphosate poisoning always died within a few hours. Extracorporeal membrane pulmonary oxygenation (ECMO), as an artificial heart-lung supporting system, can be applied to support lung that is expected to recover from reversible pathological damage. However, to our knowledge, the application of ECMO for patients with diquat and glyphosate poisoning has not been reported.
A 40-year-old man ingested in 100 ml of diquat (20 g/100 ml) and 400 ml glyphosate (41 g/100 ml) was admitted to the intensive care unit (ICU), immediately complicated by the development of ventricular fibrillation, respiratory failure, renal failure, and multi-organ failure.
Diquat and glyphosate poisoning were diagnosed by stated ingestion history, and the diagnostic criteria for acute respiratory distress syndrome (ARDS) and multi-organ dysfunction syndrome were also met.
He was treated with veno-venous ECMO.
He was successfully transferred out of the ICU on day 46 and discharged on day 67. The computed tomography scan showed no obvious pulmonary fibrosis 2 months after poisoning.
ECMO may be effective in the treatment of patients with severe ARDS caused by diquat and glyphosate poisoning when conventional management does not work.
由于缺乏解毒剂或有效治疗方法，重度急性敌草快和草甘膦中毒患者通常会在数小时内死亡。体外膜肺氧合（ECMO）作为一种人工心肺支持系统，可用于支持有望从可逆性病理损伤中恢复的肺。然而，据我们所知，ECMO在敌草快和草甘膦中毒患者中的应用尚未见报道。
一名40岁男性摄入100毫升敌草快（20克/100毫升）和400毫升草甘膦（41克/100毫升）后被收入重症监护病房（ICU），随即出现心室颤动、呼吸衰竭、肾衰竭和多器官功能衰竭。
根据所述摄入史诊断为敌草快和草甘膦中毒，同时符合急性呼吸窘迫综合征（ARDS）和多器官功能障碍综合征的诊断标准。
对其进行了静脉-静脉ECMO治疗。
他于第46天成功转出ICU，并于第67天出院。中毒2个月后的计算机断层扫描显示无明显肺纤维化。
当传统治疗方法无效时，ECMO可能对治疗由敌草快和草甘膦中毒引起的重度ARDS患者有效。
