The importance of hemodialysis in intoxications with 3 case reports

Yıl 2020, Cilt: 11 Sayı: 4, 108 - 110, 28.12.2020

Veysel Garani Soylu Ayşe Yılmaz Öztürk Taşkın Ufuk Demir Bülent Uyar

https://doi.org/10.33706/jemcr.794850

Öz

Introduction: While many intoxication cases are cured with medical treatment, antidote therapy and symptomatic treatment; some cases may need hemodialysis treatment or even invasive mechanical ventilation support. We aimed to examine the place of hemodialysis in three rare intoxication cases seen in our hospital.
Case Reports: 43-year-old male patient was admitted to the emergency service with metformin intoxication . The patient with type B lactic acidosis was treated with urgent hemodialysis After a session of hemodialysis, the clinical and laboratory data returned to normal. 19-year-old female patient admitted to the emergency service with theophylline intoxication. The blood theophylline level was toxic.The patient with symptoms of intoxication (tachycardia, hypokalemia, severe nausea and vomiting, etc.) regressed after a session of hemodialysis . 22-year-old mental retarded male patient was admitted to the emergency service with loss of consciousness. The patient with metabolic acidosis was taken to the intensive care unit with coma of unknown cause. 4 sessions of hemodialysis was applied to the patient who developed acute renal failure. It was learned that the patient drank ethylene glycol (antifreeze).
Result: All our patients could be discharged with full recovery.Hemodialysis treatment has an important place in the treatment of intoxication cases.

Anahtar Kelimeler

Intoxication, Hemodialysis, Intensive Care Unıt

Kaynakça

• 1. Goktas, U., Isık, Y., Cegin, M. B., Soyoral, L., Kati, I. A. Retrospectıve analysis of the poisoning cases who were followed in our intensive care unit. Journal of Anesthesia 2011; 19 (2): 114 – 116 2. Jha VK, Padmaprakash KV. Extracorporeal Treatment in the Management of Acute Poisoning: What an Intensivist Should Know?. Indian J Crit Care Med. 2018;22(12):862-869. doi:10.4103/ijccm.IJCCM_425_18
• 3. Biradar V, Moran JL, Peake SL, Peter JV. Metformin-associated lactic acidosis (MALA): clinical profile and outcomes in patients admitted to the intensive care unit. Crit Care Resusc. 2010;12(3):191-195.
• 4. Nguyen HL, Concepcion L. Metformin intoxication requiring dialysis. Hemodial Int. 2011;15 Suppl 1:S68-S71. doi:10.1111/j.1542-4758.2011.00605.x
• 5. Friesecke S, Abel P, Roser M, Felix SB, Runge S. Outcome of severe lactic acidosis associated with metformin accumulation. Crit Care. 2010;14(6):R226. doi:10.1186/cc9376
• 6. Çevik Y, Kavalcı C, Daş M, İzdeş S. Severe theophylline intoxication, rhabdomyolysis, disseminated intravascular coagulopathy and death: Case report. AKATOS 2010;1:24-27.
• 7. Açıkalın A, Gülen M, Kösenli Ö, Topal M. Teofilin zehirlenmesi: Hemodiyaliz mi? Hemoperfüzyon mu? AKATOS 2011;2(3):39-41. doi: 10.5505/jaemcr.2011.87587
• 8. Latus J, Kimmel M, Alscher MD, Braun N. Ethylene glycol poisoning: a rare but life-threatening cause of metabolic acidosis-a single-centre experience. Clin Kidney J. 2012;5(2):120-123. doi:10.1093/ckj/sfs009.
• 9. Lister, D., Tierney, M., Dickinson, G . Effectiveness of IV ethanol therapy combined with hemodialysis in the treatment of methanol and ethylene glycol poisoning. The Canadian Journal of Hospital Pharmacy, 2005 ;58(3):142-147
• 10. Buchanan JA, Alhelail M, Cetaruk EW, Schaeffer TH, Palmer RB, Kulig K, et al. Massive ethylene glycol ingestion treated with fomepizole alone-a viable therapeutic option. J Med Toxicol. 2010 ;6(2):131-134. doi: 10.1007/s13181-010-0061-2.