심정지 및 심각한 뇌병변 장애를 초래한 전자 담배용 Nicotine 중독 1례
Cardiac arrest and severe encephalopathy following e-cigarette nicotine intoxication: a case report
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Traditionally, most cases of nicotine poisoning have been due to ingestion of nicotine pesticides. However, the increasing use of electronic cigarettes (e-cigarettes) has resulted in both intentional and unintentional exposure to concentrated liquid nicotine or “eliquid” leading to an increase in nicotine poisoning cases. However, fatalities following the ingestion of the e-liquid are extremely rare. We report a rare case of cardiac arrest and severe encephalopathy following the intentional ingestion of e-liquid. We present the case of a 20-year-old woman who intentionally ingested liquid nicotine intended for e-cigarette use. She was found in asystole and experienced a return of spontaneous circulation (ROSC) after undergoing approximately 46 mins of cardiopulmonary resuscitation. Her plasma nicotine levels were >500 ng/ml. Despite aggressive supportive care, she was found to have encephalopathy consistent with severe anoxic brain injury on magnetic resonance imaging. In recent times, there have been some reports of deaths following liquid nicotine ingestion. Our case illustrates the potential for fatal nicotine toxicity from ingestion of e-cigarettes.
Abstract
Traditionally, most cases of nicotine poisoning have been due to ingestion of nicotine pesticides. However, the increasing use of electronic cigarettes (e-cigarettes) has resulted in both intentional and unintentional exposure to concentrated liquid nicotine or “eliquid” leading to an increase in nicotine poisoning cases. However, fatalities following the ingestion of the e-liquid are extremely rare. We report a rare case of cardiac arrest and severe encephalopathy following the intentional ingestion of e-liquid. We present the case of a 20-year-old woman who intentionally ingested liquid nicotine intended for e-cigarette use. She was found in asystole and experienced a return of spontaneous circulation (ROSC) after undergoing approximately 46 mins of cardiopulmonary resuscitation. Her plasma nicotine levels were >500 ng/ml. Despite aggressive supportive care, she was found to have encephalopathy consistent with severe anoxic brain injury on magnetic resonance imaging. In recent times, there have been some reports of deaths following liquid nicotine ingestion. Our case illustrates the potential for fatal nicotine toxicity from ingestion of e-cigarettes.
참고문헌 (14)
- 김정호, "전자담배용 니코틴 원액 음독 후 발생한 심정지 1례", 대한임상독성학회지, 16(2), pp.172~175 (2018), 대한임상독성학회[DOI]
- 최지운, "전자담배 용액의 피하 주사에 의한 급성 니코틴 중독 1례", 대한임상독성학회지, 15(1), pp.60~64 (2017), 대한임상독성학회[DOI]
- 양시용, "액상형 전자담배 용액에 의한 급성 니코틴 중독: 증례보고의 체계적 고찰", 대한임상독성학회지, 18(2), pp.51~56 (2020), 대한임상독성학회[DOI]
- Neuberger M, "Tobacco, Nicotine and Health", Medicina(Kaunas), 57(8), pp.740~ (2021)
- Rom O, "Are E-cigarettes a safe and good alternative to cigarette smoking?", Ann N Y Acad Sci, 1340, pp.65~74 (2015)
- Kennedy RD, "Global approaches to regulating electronic cigarettes", Tob Control, 26(4), pp.440~445 (2017)
- Tzortzi A, "A Systematic Literature Review of E-Cigarette-Related Illness and Injury : Not Just for the Respirologist", Int J Environ Res Public Health, 17(7), pp.2248~ (2020)
- Scarpino M, "Severe neurological nicotine intoxication by e-cigarette liquids : Systematic literature review", Acta Neurol Scand, 143(2), pp.121~130 (2021)
- Maessen GC, "Nicotine intoxication by e-cigarette liquids : a study of case reports and pathophysiology", Clin Toxicol(Phila), 58(1), pp.1~8 (2020)
- Paik JH, "Symptomatic bradycardia due to nicotine intoxication", Rev Bras Ter Intensiva, 30(1), pp.121~126 (2018)
- Iida A, "Cardiac arrest due to liquid nicotine intoxication : a case report", Acute Medicine & Surgery, 8, pp.e720~ (2021)
- Scarpino M, "Brain death following ingestion of E-cigarette liquid nicotine refill solution", Brain Behav, 10(9), pp.e01744~ (2020)
- An Deok Seo, "Accidental ingestion of E-cigarette liquid nico- tine in a 15-month-old child: an infant mortality case of nicotine intoxication", Clinical and Experimental Pediatrics, 59(12), pp.490~493 (2016), 대한소아청소년과학회
- Lee YH, "Trends and sociodemographic factors of e-cigarette use among adult daily smokers in South Korea", Int J Health Plann Manage, 35(4), pp.960~969 (2020)
