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Chloral Hydrate Overdose Survived after Cardiac Arrest with Excellent Response to Intravenous β-blocker

Shaik Karimulla Shakeer1, Babji Kalapati1, Suad Abdullah Al Abri2

  • 1Department of Anesthesia and ICU, Sultan Qaboos University Hospital, Muscat, Oman.

Oman Medical Journal
|May 22, 2019
PubMed

Insights

Chloral hydrate (CH) poisoning, though rare, can cause severe neurotoxicity and cardiotoxicity, even cardiac arrest. Prompt recognition and treatment with beta-blockers can lead to a full recovery.

Area of Science:

  • Toxicology
  • Cardiology
  • Emergency Medicine

Background:

  • Chloral hydrate (CH) is a sedative used in outpatient procedures, despite potential toxicity.
  • CH poisoning is infrequently encountered in emergency settings.

Observation:

  • A case of CH poisoning presented with neurotoxicity, progressing to cardiotoxicity and cardiac arrest.
  • The patient experienced severe cardiac arrhythmias unresponsive to standard treatments.

Findings:

  • Successful resuscitation and recovery were achieved with a high index of suspicion and appropriate management.
  • Beta-blockers were identified as a key intervention for CH-induced refractory arrhythmias.

Implications:

  • Highlights the importance of considering CH toxicity in patients with unexplained neurological and cardiac events.
  • Suggests beta-blockers as a targeted therapy for managing chloral hydrate-induced cardiac arrhythmias.
  • Emphasizes the need for careful consideration of sedative choices in outpatient procedures.

Keywords:
Cardiac ArrestCardiac ArrhythmiasCentral Nervous System DepressantsChloral HydratePoisoning

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