Cheng-Wei Chan1, I-Lin Wu, Ching-Hsing Lee, Shou-Chien Hsu, Shu-Chen Liao. 1. 1Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan.2College of Medicine, Chang Gung University, Taoyuan, Taiwan.3Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.4Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Abstract
OBJECTIVE: To describe the experience of emergency extracorporeal membrane oxygenation in treating life-threatening glyphosate-surfactant intoxication. DESIGN: Case report. SETTING: Emergency department and ICU. PATIENT: A patient with cardiopulmonary failure after glyphosate-surfactant intoxication. INTERVENTION: Extracorporeal membrane oxygenation. CASE REPORT: A 47-year-old man presented with mildly decreased consciousness in our emergency department after ingesting approximately 100 mL of glyphosate-surfactant 1.5 hours previously. Respiratory failure, persistent ventricular tachycardia, profound shock refractory to inotropic agents, and metabolic acidosis developed in the patient within 2 hours. Extracorporeal membrane oxygenation was applied within 4 hours of cardiopulmonary failure. The patient's condition improved considerably. He was transferred to the general ward on the eighth day with stable hemodynamic status and complete neurological recovery. CONCLUSIONS: On the basis of our research, this was the first case in which extracorporeal membrane oxygenation was used to treat severe glyphosate-surfactant intoxication. We recommend early initiation of extracorporeal membrane oxygenation therapy to mitigate cardiopulmonary compromise in patients with glyphosate-surfactant intoxication.
OBJECTIVE: To describe the experience of emergency extracorporeal membrane oxygenation in treating life-threatening glyphosate-surfactant intoxication. DESIGN: Case report. SETTING: Emergency department and ICU. PATIENT: A patient with cardiopulmonary failure after glyphosate-surfactant intoxication. INTERVENTION: Extracorporeal membrane oxygenation. CASE REPORT: A 47-year-old man presented with mildly decreased consciousness in our emergency department after ingesting approximately 100 mL of glyphosate-surfactant 1.5 hours previously. Respiratory failure, persistent ventricular tachycardia, profound shock refractory to inotropic agents, and metabolic acidosis developed in the patient within 2 hours. Extracorporeal membrane oxygenation was applied within 4 hours of cardiopulmonary failure. The patient's condition improved considerably. He was transferred to the general ward on the eighth day with stable hemodynamic status and complete neurological recovery. CONCLUSIONS: On the basis of our research, this was the first case in which extracorporeal membrane oxygenation was used to treat severe glyphosate-surfactant intoxication. We recommend early initiation of extracorporeal membrane oxygenation therapy to mitigate cardiopulmonary compromise in patients with glyphosate-surfactant intoxication.
Authors: Adeel Abbasi; Cynthia Devers; Christopher S Muratore; Colin Harrington; Corey E Ventetuolo Journal: J Crit Care Date: 2017-10-18 Impact factor: 3.425