当服用过量时:在烯酸毒性中成功使用血液透析
Stella Zaringhalam1, Harpreet Dosanjh1, Waleed A Awan1
1Internal Medicine, Los Robles Regional Medical Center, Thousand Oaks, USA.
Cureus
|August 8, 2025
概括
严重的酸 (VPA) 毒性需要积极的管理. 连续脏替代疗法 (CRRT) 有效地消除了VPA,改善了严重过量患者的治疗结果.
科学领域:
- 药理学 药理学是指药理学的学科.
- 毒理学 毒理学 毒理学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 瓦尔酸 (VPA) 过量服用可能导致严重的毒性,包括中枢神经系统抑郁和多器官衰竭.
- 管理严重的VPA毒性是具有挑战性的,有效的去除策略有限.
- 这个案子涉及一个年轻的成年人,他滥用多种物质和自杀念头,并过量服用VPA.
研究的目的:
- 在怀疑过量后,报告一名年轻成年男性严重的氨酸毒性病例.
- 评估持续置换疗法 (CRRT) 在治疗严重VPA毒性的有效性.
主要方法:
- 一个病例报告,一名21岁的男性在怀疑过量后血清中氨酸水平高 (879微克/毫升).
- 最初的治疗包括支持性护理,活性炭和L-卡尼丁,随后由于缺乏改善而启动CRRT.
主要成果:
- 由于严重的VPA毒性,患者呈现出改变的精神状态.
- CRRT促进了氨酸的快速去除,导致病人的精神状况逐渐改善.
- 在住院三天后,成功地进行了输出管和恢复.
结论:
- 严重的酸毒性需要早期识别和积极的治疗策略.
- 连续脏替代疗法 (CRRT) 可以成为一种有价值的干预措施,以提高氨酸清除率,并改善严重过量病例患者的治疗结果.
- 及时应用CRRT可以显著降低与酸毒性相关的死亡率和发病率.
更多相关视频
10:42Ex Vivo Expansion of Hematopoietic Stem Cells from Human Umbilical Cord Blood-derived CD34+ Cells Using Valproic Acid
Published on: April 11, 2019
10.0K
06:10Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
3.4K
相关概念视频
01:24Hemodialysis II: Procedure and Complications
133
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
133
01:25Hemodialysis I: Introduction
293
Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
293
01:25Hemodialysis III: Nursing Management
188
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
188
01:27Dialysis
479
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
479
01:26Enhanced Elimination of Poison
581
Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures.
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
581
01:11Renal Failure: Dose Adjustments
158
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
158