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基于农村三级医疗重症监护病房的百草枯中毒病例回顾

Review of a Case of Paraquat Poisoning in a Tertiary Care Rural-based ICU.

作者信息

Sharma Deepak S, Prajapati Abhishek M, Shah Dhruv M

机构信息

Department of Critical Care, King's College Hospital, London, United Kingdom.

Department of Critical Care, Shree Krishna Hospital, Karamsad, Anand, Gujarat, India.

出版信息

Indian J Crit Care Med. 2019 Jun;23(6):284-286. doi: 10.5005/jp-journals-10071-23182.

Abstract

UNLABELLED

Paraquat (1,1'-dimethyl-4, 4'-dipyridylium) is a broad-spectrum liquid herbicide associated with both accidental and intentional ingestion leading to severe and often fatal toxicity. Paraquat is actively taken up against a concentration gradient into lung tissue leading to pneumonitis and lung fibrosis. Paraquat also causes renal and liver injury. There are few case publications of paraquat poisoning and only few of them have reported that renal failure has ensued before acute respiratory distress syndrome (ARDS). Our patient presented with above lethal dose intake of paraquat containing substance and we did gastric lavage followed by charcoal hemoperfusion and hemodialysis but patient could not be saved despite optimum efforts suggesting the high fatality of this kind of poisoning.

HOW TO CITE THIS ARTICLE

Sharma DS, Prajapati AM, Shah DM. Review of a Case of Paraquat Poisoning in a Tertiary Care Rural-based ICU. Indian J Crit Care Med 2019;23(6):284-286.

KEY MESSAGES

Acute renal injury with hypoperfusion state due to toxicity at cellular level, redox cycling and intracellular reactive oxidative stress generation may also cause death in early stages in paraquat poisoning despite optimal management.

摘要

未标注

百草枯(1,1'-二甲基-4,4'-联吡啶鎓)是一种广谱液体除草剂,与意外和故意摄入有关,可导致严重且往往致命的毒性。百草枯会逆浓度梯度主动摄取进入肺组织,导致肺炎和肺纤维化。百草枯还会引起肾和肝损伤。关于百草枯中毒的病例报道很少,其中只有少数报道在急性呼吸窘迫综合征(ARDS)之前就已出现肾衰竭。我们的患者摄入了超过致死剂量的含百草枯物质,我们进行了洗胃,随后进行了活性炭血液灌流和血液透析,但尽管尽了最大努力,患者仍未能获救,这表明这种中毒的死亡率很高。

如何引用本文

夏尔马DS、普拉贾帕蒂AM、沙阿DM。基于农村三级护理重症监护病房的百草枯中毒病例回顾。《印度重症监护医学杂志》2019年;23(6):284 - 286。

关键信息

尽管进行了最佳治疗,但在百草枯中毒早期,由于细胞水平的毒性、氧化还原循环和细胞内活性氧化应激的产生导致的急性肾损伤伴低灌注状态也可能导致死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5afc/6698351/24ed4df34635/ijccm-23-284-g001.jpg

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