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hemodialysis poisoning

J Wolter, D Grün, S Otto
We report the case of a young man who took a large amount of caffeine powder dissolved in water in a suicide attempt. He was found comatose. The initial diagnosis was difficult. In hospital he suffered from rhabdomyolysis with renal failure and sepsis rapidly developed. After renal replacement treatment with hemodialysis, long-term artificial ventilation with tracheotomy and a 3‑week stay in the intensive care unit, the patient could be discharged to a rehabilitation center.
February 21, 2018: Der Anaesthesist
Brandon J Warrick, Andrew King, Susan Smolinske, Ronald Thomas, Cynthia Aaron
BACKGROUND/OBJECTIVES: The threshold salicylate concentration commonly recommended to initiate extracorporeal elimination, in the absence of significant end-organ toxicity, is 100 mg/dL. Unfortunately, the grade of evidence to support this decision is low. Our primary aim is to describe highest reported salicylate concentrations in patients who died from acute salicylate ingestions. Our secondary aim is to determine if age or coingestants varied with highest reported salicylate concentration...
February 12, 2018: Clinical Toxicology
X Yang, S Y Qian, Y M Zhu, X Xu, C F Liu, F Xu, X X Ren, Y Wang, Y C Zhang, G P Lu
Objective: To investigate the current application status of continuous blood purification (CBP) technology and equipment in pediatric intensive care unit (PICU) in China. Methods: A cross-sectional survey was conducted to understand the current popularization of CBP technology and equipment, the management of CBP equipment and consumables, and the application of CBP in different diseases. A questionnaire named Application Status of Continuous Blood Purification Technology was applied. Children's hospitals and polyclinic hospitals with the pediatric qualification (pediatric emergency or critical care unit members of Chinese Medical Association and Chinese Medical Doctor Association) were selected...
February 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Patrick Chow Yuen Ng, Brit J Long, William Tyler Davis, Daniel J Sessions, Alex Koyfman
Toxic alcohols are a group of substances containing a hydroxyl group not meant to be ingested. They are the cause of a significant number of accidental and non-accidental exposures. Toxic alcohol poisoning can be associated with a significant degree of morbidity and mortality if not promptly recognized and treated. This review describes the clinical presentation and an approach to the recognition and management for toxic alcohol poisoning. Toxic alcohols classically refer to a group of alcohols not meant for ingestion...
February 9, 2018: Internal and Emergency Medicine
Chang Hun Song, Hong Jin Bae, Young Rok Ham, Ki Ryang Na, Kang Wook Lee, Dae Eun Choi
Ethylene glycol is a widely used and readily available substance. Ethylene glycol ingestion does not cause direct toxicity; however, its metabolites are highly toxic and can be fatal even in trace amounts. Poisoning is best diagnosed through inquiry, but as an impaired state of consciousness is observed in most cases, poisoning must be suspected when a significantly elevated osmolar gap or high anion gap metabolic acidosis is found in blood tests. Hemodialysis and alcohol dehydrogenase inhibitors such as ethanol and fomepizole are a part of the basic treatment, and timely diagnosis and treatment are crucial because any delays can lead to death...
December 2017: Electrolyte & Blood Pressure: E & BP
Alexander W Labossiere, Dennis F Thompson
OBJECTIVES: Yew plant materials contain highly toxic taxine alkaloids. Serious ingestions can result in life-threatening toxicity. The purpose of this article is to summarize the literature on the treatment of acute yew poisoning. DATA SOURCES: PubMed (January 1946 to November 2017) was searched using the search terms "taxus/po". EMBASE (1980 to November 2017) was searched using the search terms "taxus/to" and "" Web of Science (1945 to November 2017) was searched using the text words taxus, taxine, and yew...
January 1, 2018: Annals of Pharmacotherapy
Baran S Kizilyildiz, Kamuran Karaman, Selvi Özen, Abdurrahman Üner
BACKGROUND: The aim of this study was to investigate characteristics, outcomes and clinical features of acute intoxications among children in Van region of Turkey. METHODS: All cases with a diagnosis of acute intoxication admitted to the Pediatric Emergency Department of the Yüzüncü Yıl University of Van from June 1, 2010 to November 30, 2011 were evaluated. We retrospectively examined the medical records for demographical and etiological characteristics of patients below 17 years of age...
February 2018: Minerva Pediatrica
Qinhua Pu, Jinxian Qian, Weiyi Tao, Aixiang Yang, Jian Wu, Yaodong Wang
RATIONALE: Hydrofluoric acid (HF) is a highly corrosive agent and can cause corrosive burns. HF can penetrate deeply into tissues through intact skin and the lipid barrier, leading to painful liquefactive necrosis, and inducing hypocalcemia and hypomagnesemia. In this study, we hypothesize that continuous renal replacement therapy (CRRT) may be beneficial in addressing hemodynamic instability in cases of HF poisoning. PATIENT CONCERNS: A 25-year-old man fell into an electroplating pool containing 10% HF and 50% nitric acid...
December 2017: Medicine (Baltimore)
Jérémy Zaworski, Marie Frimat, Marion Duval, Camille Saint-Jacques, Élise Bouderlique, François Glowacki, Christian Noël, Marc Hazzan, François Provôt
We report a case of a 43 years old man who was intoxicated by a 25g vancomycin overload. An anuric acute renal failure rapidly occured. The vancomycinemia was measured as high as 360mg/L (normal range: 15-35mg/L). We started an intermittent hemodialysis program to clear out the vancomycin. The vancomycinemia decreased below the treshold of our laboratory after the eighth session. Three supplementary sessions were needed because of a persistant oliguria. The kidney function slowly improved and was back to normal (seric creatinin: 80micromol/L) 3 weeks after the patient had gone home...
December 30, 2017: Néphrologie & Thérapeutique
Rokea A El-Azhary, Michael Z Wang, Ashley B Wentworth, LaTonya J Hickson
BACKGROUND: Extracorporeal treatments such as hemodialysis and plasma exchange are lifesaving measures in the treatment of drug poisoning. This treatment method generally is not used for severe cutaneous and systemic drug reactions. METHODS: Here, we describe three cases wherein hemodialysis therapy was instrumental in reversing the adverse drug reaction. RESULTS: In the cases of severe cutaneous drug reactions reviewed, patients presented with linear immunoglobulin A bullous dermatosis, acute generalized exanthematous pustulosis, and toxic epidermal necrolysis...
November 22, 2017: International Journal of Dermatology
Qiuying Lu, Zilong Liu, Xiaorui Chen
RATIONALE: Metallic mercury poisoning through intravenous injection is rare, especially for a homicide attempt. Diagnosis and treatment of the disease are challenging. PATIENT CONCERNS: A 34-year-old male presented with pyrexia, chill, fatigue, body aches, and pain of the dorsal aspect of right foot. Another case is that of a 29-year-old male who committed suicide by injecting himself metallic mercury 15 g intravenously and presented with dizzy, dyspnea, fatigue, sweatiness, and waist soreness...
November 2017: Medicine (Baltimore)
Janelle O Poyant, Robert Albright, Jeremy Clain, Govind Pandompatam, Erin F Barreto
BACKGROUND: Butalbital is a small molecule (approximately 220 Da), with 26% protein binding, a 0.8 L/kg volume of distribution, and is eliminated nearly 80% unchanged in the urine. Although hemodialysis has been used to treat overdoses of other barbiturates, the extracorporeal clearance of butalbital is unknown. The objective of this case is to describe the use of extracorporeal therapy to augment elimination of butalbital after an overdose of aspirin 325 mg-butalbital 50 mg-caffeine 40 mg with codeine 30 mg (Fiorinal with Codeine)...
November 10, 2017: Clinical Toxicology
Hong Xiang, Yajuan Zhou, Changlin Zhou, Shiguang Lei, Hong Yu, Yafang Wang, Shu Zhu
INTRODUCTION: Guizhou Province in China has an abundant resource of wild mushrooms, including numerous poisonous species which contain various toxins. The mortality rate from wild mushroom poisoning has been high in this area in recent years. Galerina sulciceps is a dangerously toxic mushroom which can be fatal if ingested. METHODS: we report on an epidemiological investigation of G. sulciceps poisoning which occurred in Duyun City of Guizhou Province. The characteristics of this species, its toxicity, observed clinical features, laboratory data, treatment modality, and prognosis were investigated in order to provide a reference point for the prevention and treatment of this kind of mushroom poisoning...
October 20, 2017: Clinical Toxicology
Hossein Hassanian-Moghaddam, Hooman Bahrami-Motlagh, Nasim Zamani, Seyed Amirhossein Fazeli, Behdad Behnam
Brain hemorrhages are rare complications of acute methanol poisoning. There is a debate on association of brain hemorrhage in methanol toxicity and application of systemic anticoagulation during hemodialysis (HD). A 70-year-old male presented to us with severe metabolic acidosis and a methanol level of 7.6 mg/dL. Ethanol and folinic acid were administered, and HD was performed. Brain computed tomography (CT) scan which was normal on presentation showed extensive bilateral subcortical supratentorial hypodensities on the 3(rd) day after commencing the treatment...
July 2017: Journal of Research in Pharmacy Practice
Rizwan Zafar, Kamran Munawar, Adeel Nasrullah, Shujaul Haq, Haider Ghazanfar, Abu Baker Sheikh, Ali Y Khan
Organophosphate (OP) poisoning is a commonly seen condition in many countries. OP poisoning classically presents with symptoms of cholinergic excess. It can rarely affect other organ systems but when it does, it can worsen a patient's overall prognosis. We present a case of a 23-year-old man with an extremely rare case of acute kidney injury due to OP, who was successfully treated with a combination of hemodialysis, atropine and pralidoxime days after OP poisoning with reservations on the aging process.
July 27, 2017: Curēus
Cheng-Hao Weng, Hui-Hsiang Chen, Ching-Chih Hu, Wen-Hung Huang, Ching-Wei Hsu, Jen-Fen Fu, Wey-Ran Lin, I-Kwan Wang, Tzung-Hai Yen
Paraquat intoxication is characterized by multi-organ failure, causing substantial mortality and morbidity. Many paraquat patients experience acute kidney injury (AKI), sometimes requiring hemodialysis. We observed 222 paraquat-intoxicated patients between 2000 and 2012, and divided them into AKI (n = 103) and non-AKI (n = 119) groups. The mortality rate was higher for AKI than non-AKI patients (70.1% vs. 40.0%, P < 0.001). Patients with AKI had a longer time to hospital arrival (P = 0.003), lower PaO2 (P = 0...
August 1, 2017: Oncotarget
Kanitha Sovann
We report the case of a 22-year-old woman with a 3-day history of watery stool, generalized abdominal pain, repeated vomiting, and decreased urine output following the consumption of fish gallbladder for self-treatment of acne. She was admitted and received empirical antiemetic, proton pump inhibitor, and intravenous saline treatment. Urine output reduced drastically with markedly elevated urea and creatinine, and she underwent urgent hemodialysis (HD). Based on thorough history taking and prompt biochemical investigations that showed extremely high urea and creatinine levels, we made a diagnosis of acute kidney injury (AKI) secondary to fish gallbladder poisoning...
2017: Blood Purification
Anna Pratsinis, Stefanie Zuercher, Vincent Forster, Eric J Fischer, Paola Luciani, Jean-Christophe Leroux
Compared to hemodialysis, peritoneal dialysis represents a more straightforward and less invasive alternative, though current solutions are not as effective. Herein, the feasibility of liposome-supported enzymatic peritoneal dialysis (LSEPD) is explored to increase the functionality of peritoneal dialysis for the model indication acute alcohol poisoning. Enzyme-loaded liposomes (E-Liposomes) containing alcohol metabolizing enzymes, alcohol oxidase and catalase, are developed and their in vitro and in vivo performances investigated...
August 14, 2017: Biomaterials
Ikuyo Narita, Michiko Shimada, Norio Nakamura, Reiichi Murakami, Takeshi Fujita, Wakako Fukuda, Hirofumi Tomita
BACKGROUND: Ethylene glycol intoxication causes severe metabolic acidosis and acute kidney injury. Fomepizole has become available as its antidote. Nevertheless, a prompt diagnosis is not easy because patients are often unconscious. Here we present a case of ethylene glycol intoxication who successfully recovered with prompt hemodialysis. CASE PRESENTATION: A 52-year-old Japanese male was admitted to a local hospital due to suspected food poisoning. The patient presented with nausea and vomiting, but his condition rapidly deteriorated, with worsening conscious level, respiratory distress requiring mechanical ventilation, hypotension, and severe acute kidney injury...
2017: Case Reports in Nephrology
Yohei Komaru, Ryota Inokuchi, Yoshihiro Ueda, Masaomi Nangaku, Kent Doi
A 35-year-old woman intentionally took 40,000 mg of lithium carbonate, and she was transferred to our hospital with nausea, vomiting, and diarrhea. She was diagnosed as having bipolar disorder 10 years ago and was receiving oral lithium therapy. Blood test results on arrival were remarkable for a negative anion gap of -2.1 and later, the serum lithium level turned out to be as high as 15.4 mEq/L. Intubation was required because of disrupted consciousness, and continuous hemodiafiltration (CHDF) was immediately started in the intensive care unit to obtain constant removal of lithium...
August 10, 2017: Hemodialysis International
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