Bologa Cristina, Lionte Catalina, Popescu Alexandra, Sorodoc Victorita, Sorodoc Laurentiu
Internal Medicine and Clinical Toxicology Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
2nd Medical Clinic, "Sf. Spiridon" Emergency Clinical County Hospital, 700111 Iasi, Romania.
Healthcare (Basel). 2021 Jun 4;9(6):671. doi: 10.3390/healthcare9060671.
Acute antiarrhythmics poisoning represents a challenge in the Emergency Department (ED). These patients often develop malignant arrhythmias in need of exceptional therapeutic measures in the ICU. We report a 47-year-old patient admitted to the ED 5 h after the ingestion of a large dose of amiodarone and flecainide in a suicide attempt. During their ED stay, the patient developed signs of cardiotoxicity evidenced by electrocardiogram and ventricular arrhythmias. The toxicological results showed a level of 4.8 mg/L amiodarone and 2.98 mg/L flecainide. He was successfully treated in the ED using a large dose of sodium bicarbonate and lipid emulsion therapy. After hospital admission, he remained stable, with no need for exceptional therapeutic measures such as mechanical circulatory support, cardiac pacing or ECMO. We emphasize the importance of an early start of pharmacological therapies in the ED, which might improve the outcome in antiarrhythmic acute poisoning.
急性抗心律失常药物中毒是急诊科面临的一项挑战。这些患者常出现恶性心律失常，需要在重症监护病房采取特殊治疗措施。我们报告一名47岁患者，因自杀企图服用大剂量胺碘酮和氟卡尼5小时后被送入急诊科。在急诊科留观期间，患者出现心脏毒性体征，心电图和室性心律失常可证实。毒理学结果显示胺碘酮水平为4.8mg/L，氟卡尼水平为2.98mg/L。在急诊科，他通过大剂量碳酸氢钠和脂质乳剂治疗成功治愈。入院后，他病情稳定，无需机械循环支持、心脏起搏或体外膜肺氧合等特殊治疗措施。我们强调在急诊科尽早开始药物治疗的重要性，这可能改善抗心律失常药物急性中毒的预后。
