[Severe acute buflomedil poisoning]

The severity of the acute intoxication from buflomedil, a vasodilator with papaverinic and alpha-adrenolytic effects, remains generally underestimated. We report the case of a 18-year-old girl who ingested a high amount of buflomedil. Two hours later, she developed seizures and ventricular arrhythmias. On admission to the ICU, she was in circulatory arrest followed by deep coma with mydriasis (GCS = 3). Buflomedil blood concentration, 2 hours after admission, was 97.3 mg.L-1. Toxicological screening for other drugs was negative. Therapy included external chest compressions tracheal intubation, mechanical ventilation, epinephrine and gastric lavage. The haemodynamic status improved within the first 24 h, although she remained comatose until the fifth day. She was discharged the eight day after her admission. This observation demonstrates that the potential severity of buflomedil poisoning is mainly due to early cardiac complications. Treatment remains purely supportive.