scholarly journals Intravenous lipid emulsion in treatment of cardiocirculatory disturbances caused by glyphosate-surfactant herbicide poisoning

2016 ◽  
Vol 73 (4) ◽  
pp. 390-392 ◽  
Author(s):  
Jasmina Jovic-Stosic ◽  
Vesna Putic ◽  
Natasa Perkovic-Vukcevic ◽  
Gordana Babic ◽  
Snezana Djordjevic ◽  
...  
Keyword(s):  
Case Report ◽  
Lipid Emulsion ◽  
Genetically Modified Crops ◽  
Acute Poisoning ◽  
Commercial Products ◽  
Arterial Blood Gas ◽  
Intravenous Lipid Emulsion ◽  
Arterial Blood ◽  
Low Toxicity ◽  
Glyphosate Herbicide

Introduction. Glyphosate is the first widely used herbicide against weed in genetically modified crops. Though glyphosate itself has a low toxicity, commercial products are more dangerous because of increased toxicity due to surfactants addition. There is no specific antidote for the poisoning with glyphosate-surfactant (Gly-SH). In recent times, the efficacy of intravenous lipid emulsion (ILE) administration for the treatment of acute poisoning caused by Gly- SH has been investigated. Case Report. A 50-year-old man was admitted 3 hours after self-poisoning with herbicide containing glyphosate and polyoxyethyleneamine, as a surfactant. On admission, the patient was in a coma, hypotensive (80/50 mmHg) and without spontaneous breathing. Electrocardiogram showed widecomplex tachycardia, and arterial blood gas (ABG) revealed acidosis (pH 7.07). Conventional treatment included mechanical ventilation, intravenous fluids, bicarbonate and dopamine. As there was no improvement, ILE was started. The patient received 100 mL of 20% Intralipid? bolus followed by infusion of 400 mL over 20 minutes. Prior to expiration of infusion, a gradual rise in blood pressure was noted, and within 2 hours sinus rhythm was restored. Conclusion. This case report suggests that the use of ILE may be an additional option for the treatment of cardiocirculatory disturbances caused by commercial products of glyphosate herbicide.

scholarly journals Successful usage of intravenous lipid emulsion in treatment of acute verapamil poisoning: A case report

2017 ◽  
Vol 74 (3) ◽  
pp. 278-281 ◽  
Author(s):  
Gordana Vukovic-Ercegovic ◽  
Natasa Perkovic-Vukcevic ◽  
Snezana Djordjevic ◽  
Zoran Segrt ◽  
Olivera Potrebic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Heart Block ◽  
Lipid Emulsion ◽  
Complete Heart Block ◽  
Lipid Emulsions ◽  
Therapy Failure ◽  
Intravenous Lipid Emulsion ◽  
Arterial Blood ◽  
Verapamil Poisoning

Introduction. During the last few years, intravenous lipid emulsions have been effectively used in treatment of acute poisonings with lipophilic substances, including verapamil. Case report. A 37-year-old women presented 1 hour after ingestion of 2.8 g verapamil with hypotension and complete heart block. Because of the applied standard therapy failure and further patients impairment, Intralipid? 20% was used. Sinus rhythm was restored, arterial blood pressure increased and verapamile concentrations, both total and free decreased. Conclusion. Intravenous lipid emulsion can be important in treatment of severe acute intoxication and cardiotoxicity caused by verapamil.

scholarly journals P-Chloroaniline Poisoning Causing Methemoglobinemia: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Anna Sarah Messmer ◽  
Christian Hans Nickel ◽  
Dirk Bareiss
Keyword(s):  
Case Report ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Peripheral Oxygen Saturation ◽  
Arterial Blood Gas ◽  
Oxygen Administration ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Common Causes ◽  
Treatable Condition

Background. Methemoglobin (MetHb) most commonly results from exposure to an oxidizing chemical but may also arise from genetic, dietary, or even idiopathic etiologies.P-chloroaniline (PCA) was one of the first substances described in the context of acquired methemoglobinemia.Case Report. We report the case of a cyanotic chemistry worker who presented to our emergency department (ED) after working with PCA. His peripheral oxygen saturation (SpO2) measured by pulse oximetry was at 81% and remained on that level despite oxygen administration (100% oxygenation via nonrebreather mask). His MetHb level was measured at 42.8% in arterial blood gas analysis. After treatment with intravenous methylene blue cyanosis resolved and the patient was discharged after 36 hours of observation.Conclusion. Acquired methemoglobinemia is a treatable condition, which may cause significant morbidity and mortality. The knowledge about the most common causes, fast diagnostic, and proper treatment is crucial.

scholarly journals Epinephrine Impairs Lipid Resuscitation from Bupivacaine Overdose

2009 ◽  
Vol 111 (3) ◽  
pp. 498-505 ◽  
Author(s):  
David B. Hiller ◽  
Guido Di Gregorio ◽  
Richard Ripper ◽  
Kemba Kelly ◽  
Malek Massad ◽  
...  
Keyword(s):  
Lipid Emulsion ◽  
Spontaneous Circulation ◽  
Serum Lactate ◽  
Circulation Rate ◽  
Rate Pressure Product ◽  
Arterial Blood Gas ◽  
Return Of Spontaneous Circulation ◽  
Arterial Blood ◽  
Lipid Resuscitation ◽  
Lipid Control

Background Lipid emulsion infusion reverses local anesthetic-induced cardiac toxicity, but the effect of adding epinephrine has not been studied. We compared escalating doses of epinephrine on recovery with lipid infusion in a rat model of bupivacaine overdose. Methods Rats anesthetized with isoflurane received an IV bolus of 20 mg/kg bupivacaine, producing asystole (zero time) in all animals. Ventilation (100% oxygen) and chest compressions were started immediately, and at 3 min the rats received one of six IV treatments (n = 5 for all groups): 5 ml/kg saline followed by infusion for 2 min at 1.0 ml x kg x min, and a second 5 ml/kg bolus at 5 min; or the same bolus and infusion treatment using 30% lipid emulsion plus a single injection of epinephrine at one of five doses: 0 (lipid control), 1, 2.5, 10, or 25 mcg/kg. An electrocardiogram and arterial pressure were monitored continuously, and arterial blood gas was measured at 7.5 and 15 min. Results Epinephrine improved initial return of spontaneous circulation (rate-pressure product > 30% baseline) but only 3 of 5 rats at 10 mcg/kg and 1 of 5 rats at 25 mcg/kg sustained return of spontaneous circulation by 15 min. Lipid alone resulted in slower but more sustained recovery. Epinephrine doses above a threshold near 10 mcg/kg increased lactate, worsened acidosis, and resulted in poor recovery at 15 min, as compared with lipid controls. There was tight correlation of epinephrine dose to serum lactate at 15 min. Conclusions Epinephrine over a threshold dose near 10 mcg/kg impairs lipid resuscitation from bupivacaine overdose, possibly by inducing hyperlactatemia.

scholarly journals A Case Report: Co-presenting COVID-19 Infection and Acute Drug Intoxication

2020 ◽  
Vol 4 (3) ◽  
pp. 340-343
Author(s):  
Jeremy Riekena ◽  
Irene Lee ◽  
Anita Lui ◽  
Marion-Vincent Mempin
Keyword(s):  
Case Report ◽  
Respiratory Acidosis ◽  
Altered Mental Status ◽  
Arterial Blood Gas ◽  
Atypical Symptoms ◽  
Arterial Blood ◽  
Opiate Abuse ◽  
Chief Complaints ◽  
Atypical Presentations ◽  
High Index Of Suspicion

Background: Coronavirus disease 2019 (COVID-19) has spread throughout the world since late 2019. Symptoms appear after a two-week incubation period and commonly include fever, cough, myalgia or fatigue, and shortness of breath. Case Report: A 32-year-old male with a history of opiate abuse presented to the emergency department with altered mental status. The patient was lethargic and hypoxic with improvement from naloxone. Official chest radiograph was read as normal; however, the treating clinicians noted bilateral interstitial opacities, raising concern for underlying infectious etiology. Opiates and cocaine were positive on drug screen, and an arterial blood gas on room air showed hypoxemia with respiratory acidosis. The patient was intubated during the treatment course due to persistent hypoxemia and for airway protection after resuscitation. The COVID-19 test was positive on admission, and later computed tomography showed ground-glass opacities. The patient was extubated and discharged after one week on the ventilator. Conclusion: When screening patients at and during evaluation, physicans should consider a broad differential as patients with atypical presentations may be overlooked as candidates for COVID-19 testing. As screening and evaluation protocols evolve, we emphasize maintaining a high index of suspicion for COVID-19 in patients with atypical symptoms or presenting with other chief complaints in order to avoid spreading the disease.

scholarly journals Intravenous Lipid Emulsion as an Antidote for the Treatment of Acute Poisoning: A Bibliometric Analysis of Human and Animal Studies

2016 ◽  
Vol 119 (5) ◽  
pp. 512-519 ◽  
Author(s):  
Sa'ed H. Zyoud ◽  
W. Stephen Waring ◽  
Samah W. Al-Jabi ◽  
Waleed M. Sweileh ◽  
Belal Rahhal ◽  
...  
Keyword(s):  
Bibliometric Analysis ◽  
Lipid Emulsion ◽  
Animal Studies ◽  
Acute Poisoning ◽  
Intravenous Lipid Emulsion

Severe propranolol and ethanol overdose with wide complex tachycardia treated with intravenous lipid emulsion: A case report

2011 ◽  
Vol 49 (5) ◽  
pp. 426-430 ◽  
Author(s):  
Jasmina Jovic-Stosic ◽  
Branko Gligic ◽  
Vesna Putic ◽  
Gordana Brajkovic ◽  
Radenko Spasic
Keyword(s):  
Case Report ◽  
Lipid Emulsion ◽  
Intravenous Lipid Emulsion ◽  
Wide Complex Tachycardia

Clinical Effects of the Suicide Attempt with Topiramate

2017 ◽  
Vol 41 (S1) ◽  
pp. S150-S150
Author(s):  
G. Montero ◽  
I. Alberdi ◽  
L. Niell ◽  
R.Á. Baena
Keyword(s):  
Metabolic Acidosis ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Plasma Concentrations ◽  
Gastric Lavage ◽  
Acute Poisoning ◽  
Gas Analysis ◽  
Clinical Effects ◽  
Arterial Blood Gas ◽  
Arterial Blood

ObjectivesWe report the case of a 45-year-old male diagnosed with mixed personality disorder brought the hospital for strange behavior. He is being treated with fluoxetine, lorazepam and topiramate; and visited his psychiatrist 72 hours ago.ResultsHe has an adequate level of consciousness and describes retrograde amnesia of the last 72 hours. We found blocks of thought and abnormal behaviors such as dressing and undressing or sorting his belongings repetitively. Urine was only positive for benzodiazepines. In arterial blood gas analysis it performed highlights compensated metabolic acidosis. After ruling out neurological diseases and administrating fluids i.v. the symptoms remitted, persisting only the amnesia, establishing the diagnosis of suicide attempt with topiramate.ConclusionsThe use out-of-guidelines of topiramate in personality and eating disorders is an increasingly common habit in daily clinical practice, as well as suicide attempts with this drug. In therapeutic doses, over 40% of patients taking topiramate, have asymptomatic metabolic acidosis, which in stressful situations may have clinical relevance. In case of acute poisoning, metabolic acidosis is more frequent and severe, manifesting itself by hyperventilation, hypertension and varying degrees of impaired consciousness and cognitive functions. There is also a paradoxical increase in the frequency of seizures. Treatment is supportive and there is no antidote, being lethal cases exceptional. Gastric lavage and administration of activated charcoal have limited use. The determination of plasma concentrations of topiramate is not available for most centers and is not useful in acute poisoning.

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