Zettinig G, Watzinger N, Eber B, Henning G, Klein W
Klinische Abteilung für Kardiologie, Medizinischen Universitätsklinik Graz.
Dtsch Med Wochenschr. 1997 Nov 28;122(48):1489-92. doi: 10.1055/s-2008-1047790.
A 42-year-old man was found unconscious, having swallowed 800 ml of an unknown liquid with suicidal intent. On admission, when his breath smelled strongly of acetone, he was intubated and ventilated, and several gastric lavages were performed.
The serum acetone concentration was 2000 mg/l, that in urine 2300 mg/l. The residue of the liquid in the bottle from which he had drunk was pure acetone.
DIAGNOSIS, TREATMENT AND COURSE: Acetone poisoning having been established he was carefully hyperventilated, haemofiltration was performed over 16 hours and forced diuresis with high fluid intake was undertaken. His condition quickly improved and he was extubated after 14 hours. There was no subsequent evidence of organ damage. Repeated measurements of acetone in blood and urine indicated its elimination with a half-life of 11 hours. Literature search revealed that this was the second highest concentration of acetone in blood and urine followed by survival.
This case demonstrates that, after acute acetone poisoning with an amount ten times the lethal dose, intensive care and rapid elimination of acetone can achieve sequelae-free survival.
一名42岁男性被发现昏迷，因有自杀意图吞服了800毫升不明液体。入院时，其呼出气体有强烈的丙酮气味，遂对其进行气管插管及通气，并多次进行洗胃。
血清丙酮浓度为2000毫克/升，尿中丙酮浓度为2300毫克/升。他所饮用的瓶中液体残留物为纯丙酮。
诊断、治疗及病程：确诊为丙酮中毒后，对其进行了谨慎的过度通气处理，进行了16小时的血液滤过，并大量补液进行强制利尿。其病情迅速好转，14小时后拔除气管插管。随后未发现器官损伤迹象。对血液和尿液中的丙酮进行反复测量表明，其消除半衰期为11小时。文献检索显示，这是血液和尿液中丙酮浓度第二高且患者存活的情况。
该病例表明，急性丙酮中毒剂量达致死剂量的10倍时，重症监护及快速清除丙酮可实现无后遗症存活。
