Kardiyak arrestle sonuçlanan alüminyum fosfid zehirlenmesinin başarılı yönetimi
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Tarih
2015
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Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Alüminyum fosfid alındığı zaman yüksek toksisiteye sahiptir ve nemle temas etmesi halinde fosfin gazı ortaya çıkar. Alüminyum fosfid zehirlenmesi metabolik asidoz, aritmi, akut respiratuar distres sendromu ve şoka sebep olur ve spesifik antidotu yoktur. On yedi yaşında erkek hasta 1500 mg alüminyum fosfid tabletin alımı sonucu intahar girişimi tanısı ile hastanemize sevk edildi. Bilinci açık uykuya meyilliydi. Yaşamsal parametreleri; TA: 85/56 mmHg, KTA: 88/dk, SpO2: %94, ateş: 36,4°C olarak ölçüldü. Hipotansiyon nedeniyle dopamin ve steradin infüzyonu başlandı. Solunum sıkıntısı gelişmesi ve bilincinin kapanması nedeniyle en- tübe edilip mekanik ventilatöre bağlandı. Arter kan gazı değerinde şiddetli metabolik asidoz tespit edildi ve hastaya sodyum bikar- bonat tedavisi uygulanarak metabolik asidozu düzeltildi. Zehir- lenmenin destekleyici tedavisine ek olarak hemodiyaliz uygulandı. Yoğun bakım ünitesindeki takibinde kardiyak arrest gelişti ve 10 dakika kardiyopulmoner resüsitasyon uygulandıktan sonra sinüs ritmi sağlandı. Toplam üç seans hemodiyaliz uygulanan hasta yatı- şının dokuzuncu gününde şifa ile taburcu edildi. Sonuç olarak bu olgu sunumunda hemodiyaliz aluminyum fosfid zehirlenmesinin semptomatik tedavisine katkı sağlamıştır
Aluminum phosphide has high toxicity when it is ingested, and in case of contact with moisture, phosphine gas is released. Alumi- num phosphide poisoning causes metabolic acidosis, arrhythmia, acute respiratory distress syndrome and shock, and there is no specific antidote. A 17-year-old male patient was referred to our hospital because of aluminum phosphide poisoning with 1500 mg of aluminum phosphide tablets. The patient's consciousness was clear but he was somnolent. Vital parameters were as follows: blood pressure: 85/56 mmHg, pulse: 88 beats/min, SpO2: 94%, temperature: 36.4°C. Because of hypotension, noradrenaline and dopamine infusions were started. The patient was intubated be- cause of respiratory distress and loss of consciousness. Severe met- abolic acidosis was determined in the arterial blood gas, and met- abolic acidosis was corrected by sodium bicarbonate treatment. In addition to supportive therapy of the poisoning, hemodialysis was performed. Cardiac arrest occurred during follow-ups in the intensive care unit, and sinus rhythm was achieved after 10 min of cardiopulmonary resuscitation. The patient was discharged after three sessions of haemodialysis on the ninth day. As a result, hae- modialysis contributed to symptomatic treatment of aluminum phosphide poisoning in this case report.
Aluminum phosphide has high toxicity when it is ingested, and in case of contact with moisture, phosphine gas is released. Alumi- num phosphide poisoning causes metabolic acidosis, arrhythmia, acute respiratory distress syndrome and shock, and there is no specific antidote. A 17-year-old male patient was referred to our hospital because of aluminum phosphide poisoning with 1500 mg of aluminum phosphide tablets. The patient's consciousness was clear but he was somnolent. Vital parameters were as follows: blood pressure: 85/56 mmHg, pulse: 88 beats/min, SpO2: 94%, temperature: 36.4°C. Because of hypotension, noradrenaline and dopamine infusions were started. The patient was intubated be- cause of respiratory distress and loss of consciousness. Severe met- abolic acidosis was determined in the arterial blood gas, and met- abolic acidosis was corrected by sodium bicarbonate treatment. In addition to supportive therapy of the poisoning, hemodialysis was performed. Cardiac arrest occurred during follow-ups in the intensive care unit, and sinus rhythm was achieved after 10 min of cardiopulmonary resuscitation. The patient was discharged after three sessions of haemodialysis on the ninth day. As a result, hae- modialysis contributed to symptomatic treatment of aluminum phosphide poisoning in this case report.
Açıklama
Anahtar Kelimeler
Anestezi
Kaynak
Turkish Journal of Anaesthesiology and Reanimation
WoS Q Değeri
Scopus Q Değeri
Cilt
43
Sayı
4
