Steffen C, Seitz R
Arch Toxicol. 1981 Nov;48(4):281-8. doi: 10.1007/BF00319656.
A case of severe sodium chlorate poisoning was observed within 5 h after suicidal ingestion of 150-200 g of the herbicide. Methaemoglobinaemia was the early symptom of the intoxication. Treatment with methylene blue and ascorbic acid could not prevent a massive haemolysis with disseminated intravascular coagulation. Hypercoagulation and hyperfibrinolysis could be treated successfully with exchange transfusions, heparin and fresh plasma. During the first hours, 70 mmol chlorate were excreted before complete renal failure occurred which required haemodialysis for several weeks. Clinical observations and in vitro experiments provide evidence that methylene blue is effective only in the very early stages of chlorate poisoning. Consequently, the following treatment is suggested: gastric lavage, exchange transfusion, bicarbonate infusion, haemodialysis, anticoagulation with heparin and substitution of clotting factors if necessary.
一名自杀性摄入150 - 200克除草剂的患者在5小时内出现严重氯酸钠中毒。高铁血红蛋白血症是中毒的早期症状。亚甲蓝和抗坏血酸治疗未能预防伴有弥散性血管内凝血的大量溶血。通过换血疗法、肝素和新鲜血浆成功治疗了高凝和高纤维蛋白溶解。在最初几个小时内，在发生完全肾衰竭需要进行数周血液透析之前，排出了70 mmol氯酸盐。临床观察和体外实验证明亚甲蓝仅在氯酸盐中毒的极早期有效。因此，建议采用以下治疗方法：洗胃、换血疗法、输注碳酸氢盐、血液透析、用肝素抗凝以及必要时补充凝血因子。
