Journal of toxicology. Clinical toxicology
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J. Toxicol. Clin. Toxicol. · Jan 1996
Case ReportsAcute renal failure, compartment syndrome, and systemic capillary leak syndrome complicating carbon monoxide poisoning.
Five Indian labourers sharing one room were found lying on the floor unconscious. A coal fire had been lit to provide heat during the cold night and was still burning inside the room. Two of the men were pronounced dead at the scene. ⋯ Two patients developed anuric acute renal failure due to acute tubular necrosis as shown by renal biopsy. Two patients developed the full blown picture of systemic capillary leak syndrome. Gross and microscopic examination of specimens taken at autopsy showed extensive necrosis of all skeletal muscles, myocardial necrosis and acute tubular necrosis affecting both kidneys.
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To present a child who developed gastric ulcers and duodenal erosions after ingestion of hydrogen peroxide 3% and delineate the epidemiology, medical outcomes, and toxicity of exposures to this agent managed by a poison control center. ⋯ Exposure to hydrogen peroxide 3% is usually benign, however, severe gastric injury may occur following small ingestions in children. Patients who report persistent vomiting or bloody emesis require medical evaluation and consideration of endoscopy to evaluate gastrointestinal injury.
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J. Toxicol. Clin. Toxicol. · Jan 1996
ReviewRisks of extracorporeal membrane oxygenation: is there a role for use in the management of the acutely poisoned patient?
To review the use of extracorporeal membrane oxygenation in the support of poisoned patients and provide a basis for comparison to other methods of respiratory support for these patients. ⋯ The use of extracorporeal membrane oxygenation for respiratory failure following ingestion has the same limited indications as for other patients with respiratory failure. Data supporting an improvement in outcome are not available. Extracorporeal membrane oxygenation support for reversible cardiac toxicity has a sound basis but clinical experience is limited. Good supportive care for the poisoned patient is essential before considering extracorporeal membrane oxygenation.
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J. Toxicol. Clin. Toxicol. · Jan 1996
Clinical TrialPharmacokinetics of hydroxocobalamin in smoke inhalation victims.
Hydroxocobalamin has been proposed as a cyanide antidote. Little is known, however, about its pharmacokinetics in human cyanide poisoning. ⋯ The apparent volume of distribution suggests a predominantly extracellular partitioning of the antidote, even in the presence of cyanide, an important factor in terms of its antidotal effect. Hydroxocobalamin's elimination half-life in these cyanide-exposed patients far exceeds those found in previous studies of dogs and minimally-exposed humans. If confirmed, this half-life suggests that a single dose of hydroxocobalamin, sufficiently large enough to bind the cyanide present, should be adequate.
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J. Toxicol. Clin. Toxicol. · Jan 1996
Case Reports4-Methylpyrazole and hemodialysis in ethylene glycol poisoning.
Two patients severely intoxicated with ethylene glycol became anuric and were treated by hemodialysis and the antidote, 4-methylpyrazole. On admission, their plasma ethylene glycol concentrations were 0.42 and 3 g/L respectively and no alcohol was detected. The elimination of 4-methylpyrazole in the dialysate represented 45% of the total body elimination. Clearances of 4-methylpyrazole by hemodialysis were 80 mL/min and 52 mL/min respectively. ⋯ In such cases, the authors propose infusion of a 4-methylpyrazole loading dose of 10-20 mg/kg before dialysis and intravenous infusion of 1-1.5 mg/kg/h during the 8-12 hours of hemodialysis to compensate the loss in dialysate.