Continuous renal replacement therapy increased plasma cholinesterase activity in a case of acute organophosphate poisoning
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Extracorporeal removal of organophosphate from blood has been proposed, but the efficacy of hemodialysis and hemoperfusion has not been established. We report a case of organophosphate poisoning in which continuous renal replacement therapy (CRRT) was applied with conventional indications and was found to increase plasma cholinesterase levels by hemodiafiltration. A 73-year-old male was found unconscious at home and was brought to the emergency department by ambulance. An empty bottle of Supracide insecticide, of which the active ingredient is methidathion, was found beside him. CRRT was initiated because he showed signs of oliguria and acidosis with an unstable hemodynamic condition. Although his condition improved temporarily after CRRT initiation, it subsequently deteriorated, and he died despite maximal supportive effort. His prefilter plasma cholinesterase levels remained at <200 U/L for 3 days, while his postfilter levels were 358 U/L 1 hour after CRRT initiation and they were 689 U/L 18 hours later. Our case suggests that CRRT might play a role in treating organophosphate poisoning by possibly eliminating organophosphate.
Abstract
Extracorporeal removal of organophosphate from blood has been proposed, but the efficacy of hemodialysis and hemoperfusion has not been established. We report a case of organophosphate poisoning in which continuous renal replacement therapy (CRRT) was applied with conventional indications and was found to increase plasma cholinesterase levels by hemodiafiltration. A 73-year-old male was found unconscious at home and was brought to the emergency department by ambulance. An empty bottle of Supracide insecticide, of which the active ingredient is methidathion, was found beside him. CRRT was initiated because he showed signs of oliguria and acidosis with an unstable hemodynamic condition. Although his condition improved temporarily after CRRT initiation, it subsequently deteriorated, and he died despite maximal supportive effort. His prefilter plasma cholinesterase levels remained at <200 U/L for 3 days, while his postfilter levels were 358 U/L 1 hour after CRRT initiation and they were 689 U/L 18 hours later. Our case suggests that CRRT might play a role in treating organophosphate poisoning by possibly eliminating organophosphate.
참고문헌 (8)
- Moon J, "Utility of red blood cell acetylcholinesterase measurement in mechanically ventilated subjects after organophosphate poisoning", Respir Care, 59, pp.1360~1368 (2014)
- Moshiri M, "Advances in toxicology and medical treatment of chemical warfare nerve agents", Daru, 20, pp.81~ (2012)
- Eddleston M, "Management of acute organophosphorus pesticide poisoning", Lancet, 371, pp.597~607 (2008)
- Peng A, "Therapeutic efficacy of charcoal hemoperfusion in patients with acute severe dichlorvos poisoning", Acta Pharmacol Sin, 25, pp.15~21 (2004)
- Peter JV, "Adjuncts and alternatives to oxime therapy in organophosphate poisoning:is there evidence of benefit in human poisoning? A review", Anaesth Intensive Care, 36, pp.339~350 (2008)
- Güven M, "The effect of plasmapheresis on plasma cholinesterase levels in a patient with organophosphate poisoning", Hum Exp Toxicol, 23, pp.365~368 (2004)
- Bo L, "Therapeutic efficacies of different hemoperfusion frequencies in patients with organophosphate poisoning", Eur Rev Med Pharmacol Sci, 18, pp.3521~3523 (2014)
- Bouchard J, "Availability and cost of extracorporeal treatments for poisonings and other emergency indications : a worldwide survey", Nephrol Dial Transplant, 32, pp.699~706 (2017)