...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Massive diltiazem overdose treated with extracorporeal membrane oxygenation.
【24h】

Massive diltiazem overdose treated with extracorporeal membrane oxygenation.

机译：大量地尔硫卓过量用体外膜氧合治疗。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: To describe a case of massive diltiazem overdose with a good outcome achieved after early and aggressive supportive therapy. DESIGN: Case report. SETTING: Pediatric Critical Care Unit. Patient: Sixteen-year-old adolescent girl. MEASUREMENTS AND MAIN RESULTS: A 16-yr-old adolescent girl presented to the emergency department 6 hrs after the intentional ingestion of 40 300-mg sustained-release diltiazem tablets (12 g of Cardura CD). She was hypotensive and required a glucagon and epinephrine infusion despite initial fluid resuscitation with saline and intravenous calcium (1 g). Multiple asystolic cardiac arrests ensued which became increasingly refractory to high-dose epinephrine. Hemodynamic support was achieved with a 48-hr period of extracorporeal membrane oxygenation for atrial standstill. Severe multiorgan dysfunction ensued (cardiac, neurologic, renal, hepatic, gastrointestinal, hematologic, and metabolic). Plasma diltiazem and its metabolites were measured and its half-life was reported between 28 and 48 hrs. A sustained decline in plasma diltiazem levels and its metabolites was not observed after two periods of charcoal hemoperfusion. Recovery of organ function occurred with sinus rhythm noted on the ninth day. The patient made a full recovery and was discharged from the critical care unit after 15 days. CONCLUSIONS: Although massive calcium channel blocker overdose can produce profound and prolonged cardiac or multiorgan dysfunction, its toxic effects may be reversible. Supportive therapy, particularly of the cardiovascular system, is the most important goal.
机译：目的：描述一例大剂量地尔硫卓过量并在早期积极的支持治疗后取得良好结果的病例。设计：病例报告。单位：儿科重症监护室。病人：十六岁的少女。测量和主要结果：一名16岁的少女在故意摄入40 300 mg地尔硫卓缓释片（12 g Cardura CD）后6小时出现在急诊室。尽管最初用盐水和静脉内补钙（1 g）进行液体复苏，但她仍处于低血压状态，需要胰高血糖素和肾上腺素输注。随后发生了多个心脏停搏停搏，对高剂量肾上腺素越来越难治。血液动力学支持是通过48小时的体外膜氧合作用来实现的。随之而来的是严重的多器官功能障碍（心脏，神经系统，肾脏，肝脏，胃肠道，血液学和代谢）。测定血浆地尔硫卓及其代谢产物，并报告其半衰期为28至48小时。在经过两次木炭血液灌注后，未观察到血浆地尔硫卓水平及其代谢物的持续下降。第九天注意到器官功能恢复并伴有窦性心律。患者完全康复，并在15天后从重症监护病房出院。结论：尽管大量的钙通道阻滞剂过量可以产生深远的心脏或多器官功能障碍，但其毒性作用可能是可逆的。最重要的目标是特别是心血管系统的支持治疗。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号