Department of Anesthesia and Intensive Care, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
Department of Surgical, Pediatric and Diagnostic Sciences, University of Pavia, Pavia, Italy.
Perfusion. 2024 Mar;39(2):423-425. doi: 10.1177/02676591221141327. Epub 2022 Nov 21.
Supportive care is the cornerstone of the poisoned patient's treatment, waiting for eventual antidotes to act. We recently treated a case of a severe Ethylene Glycol intoxication with early-onset veno-arterial ECMO. The patient was taken to our Emergency Department with the suspicion of acute cerebrovascular accident, since he was found unconscious at home. The arterial blood gas and blood tests showed a severe metabolic acidosis with high serum lactates and creatinine levels. The cerebral Computed Tomography was negative. The rapid increase in serum lactates suggested Ethylene Glycol intoxication. Although the patient was not in shock yet, arterial and venous introducers were placed in to the femoral vessels so that when the patient showed the first signs of cardiogenic shock, veno-arterial ECMO could be initiated in a very short time. The hemodynamic state progressively improved and V-A ECMO was removed after 16 h of support with complete recovery.
支持性治疗是中毒患者治疗的基石，等待解毒剂发挥作用。我们最近治疗了一例早期动静脉体外膜肺氧合（ECMO）的乙二醇重度中毒病例。患者因在家中昏迷被送往我院急诊科，怀疑为急性脑血管意外。动脉血气和血液检查显示严重代谢性酸中毒，血清乳酸和肌酐水平升高。头颅 CT 为阴性。血清乳酸的快速升高提示乙二醇中毒。尽管患者尚未出现休克，但股动静脉内导管已置入股动静脉内，以便当患者出现心源性休克的早期迹象时，可在极短时间内启动动静脉 ECMO。血流动力学状态逐渐改善，在支持 16 小时后，成功移除了 V-A ECMO，患者完全康复。
