严重的咖啡因中毒用mexiletine成功地通过体外方法治疗
Saeko Kohara1, Yoshito Kamijo2, Ryoko Kyan2
1Department of Clinical Toxicology, Saitama Medical University, Japan; Department of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center, Japan.
过量服用咖啡因和梅克西莱丁导致严重的毒性,需要机械通风和体外膜氧化. 血液透析有效地去除了这两种物质,有助于患者的康复和减少毒性持续时间.
科学领域:
- 毒理学 毒理学 毒理学
- 药理学 药理学是指药理学的学科.
- 临界护理医学 临界护理医学
背景情况:
- 过量服用咖啡因和美克西莱丁可以导致严重的心血管和神经毒性.
- 梅克西莱丁可能会损害咖啡因代谢,可能会延长毒性.
- 这一案例突出了严重的过量服用情景,需要密集管理.
研究的目的:
- 报告一个大量咖啡因和mexiletine过量服用的病例.
- 描述这种过量剂量的临床过程和管理.
- 评估血液透析在控制联合咖啡因和mexiletine毒性的作用.
主要方法:
- 患者在摄入18克咖啡因和3500毫克梅克西莱丁后出现了血液动力学不稳定性和精神状态的改变.
- 治疗包括机械通风,血管压力器,胃洗,活性炭,静脉动脉外体膜氧化 (VA-ECMO) 和血液透析 (HD).
- 连续监测咖啡因和麦克西莱丁的血度,并评估了HD期间的药物清除.
主要成果:
- 患者出现了无脉冲的心室动脉冲动和循环崩,需要VA-ECMO.
- 血液透析显著降低了咖啡因和梅克西莱丁的血液度.
- 患者在两次HD治疗后成功从VA-ECMO和机械通风中断奶.
结论:
- 结合咖啡因和mexiletine的过量服用可能导致危及生命的毒性.
- 血液透析是一种有效的方法,可以在过量服用时去除咖啡因和素.
- 迅速识别和积极管理,包括体外支持和血液透析,对于严重病例的生存至关重要.
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