Acute and Critical Care

Case Reports

Toxicology
Management of Cyanide Intoxication with Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy: Jin Park, Seung-Yeob Lee, Hyun-Sik Choi, Yoon Hee Choi, Young-Joo Lee; Korean J Crit Care Med. 2015;30(3):218-221. Published online August 31, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.3.218

7,378 View
87 Download
1 Crossref

Cyanide intoxication results in severe metabolic acidosis and catastrophic prognosis with conventional treatment. Indications of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) are expanding to poisoning cases. A 50-year-old male patient arrived in the emergency room due to mental change after ingestion of cyanide as a suicide attempt 30 minutes prior. He was comatose, and brain stem reflexes were absent. Initial laboratory analysis demonstrated severe metabolic acidosis with increased lactic acid of 25 mM/L. Shock and acidosis were not corrected despite a large amount of fluid resuscitation with high-dose norepinephrine and continuous renal replacement therapy. We decided to apply ECMO and CRRT to allow time for stabilization of hemodynamic status. After administration of antidote infusion, although the patient had the potential to progress to brain death status, vital signs were improved with correction of acidosis. We considered the evaluation for organ donation. We report a male patient who showed typical cyanide intoxication as lethal metabolic acidosis and cardiac impairment, and the patient recovered after antidote administration during vital organ support through ECMO and CRRT.

Citations

Citations to this article as recorded by

Cyanogenic glycoside amygdalin influences functions of human osteoblasts in vitro
Radoslav Omelka, Veronika Kovacova, Vladimira Mondockova, Birgit Grosskopf, Adriana Kolesarova, Monika Martiniakova
Journal of Environmental Science and Health, Part B.2021; 56(2): 109. CrossRef

Successful Transplantation of Organs from a Donor with Bacterial Meningitis Caused by Streptococcus pneumonia: A Case Report: Eunjung Park, Sang Cheon Choi, Youngjoo Lee, Yoonseok Jung, Younggi Min; Korean J Crit Care Med. 2013;28(2):115-118.; DOI: https://doi.org/10.4266/kjccm.2013.28.2.115

2,437 View
25 Download

Abstract PDF: The number of organs transplanted worldwide is increasing annually. As a result, there is a shortage of available donor organs. This scarcity has led to the progressive broadening of donor organ criteria. The expanded criteria include infections such as bacterial meningitis. A 55-year old male visited our emergency room with cardiac arrest and recovered after cardiopulmonary resuscitation. The cause of the cardiac arrest was bacterial meningitis caused by Streptococcus pneumoniae. While proper antibiotics were applied, the patient met the clinical criteria for brain death. Prophylactic antibiotics were administered to the recipients, and liver and kidney transplantations were done successfully.

First
Prev
Page of 1
Next
Last

Search