Treatment of severe acute organophosphate pesticide poisoning with septic shock induced by Dimethoate
10.3969/j.issn.1008-9691.2024.01.022
- VernacularTitle:由乐果导致的重度急性有机磷中毒合并脓毒性休克的治疗体会
- Author:
Yanfang ZHANG
1
;
Yao YAO
;
Ying DENG
;
Sui XIONG
;
Li MA
;
Guobing CHEN
Author Information
1. 云南省第一人民医院MICU,云南昆明 650032
- Keywords:
Acute organophosphorus pesticide poisoning;
Respiratory failure;
Intermediate syndrome;
Sepsis;
Ventilator-associated pneumonia;
Infection control
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(1):100-102
- CountryChina
- Language:Chinese
-
Abstract:
Objective To describe the diagnosis,treatment,and clinical course of a patient with severe acute organophosphorus pesticide poisoning(AOPP)complicated by recurrent respiratory failure,intermediate syndrome(IMS),multiple organ dysfunction syndrome(MODS)and sepsis.Methods On May 8,2021,a patient who self-administered the pesticide Dimethoate AOPP was admitted to the department of internal medicine intensive care unit(MICU)of the First People's Hospital of Yunnan Province.After 29 days of treatment,the patient was successfully cured and discharged.The clinical diagnosis and treatment process was introduced.Results The 78-year-old male patient suffered from severe AOPP due to self-ingestion of the pesticide leptophos.Upon admission,he rapidly developed respiratory failure requiring urgent endotracheal intubation and mechanical ventilation support.A series of targeted treatments were administered,including the use of reactivators such as pralidoxime iodide,anticholinergic agents like atropine and scopolamine,as well as antibiotic therapy and management of water-electrolyte balance and acid-base equilibrium.Throughout his treatment,the patient experienced multiple complications,including episodes of sepsis,fluctuating cholinesterase levels,infections from multidrug-resistant bacteria,and recurrent respiratory failures.After 29 days of meticulous care,the patient was successfully weaned off the ventilator,regained normal organ function,and was discharged.Conclusion The analysis of this case highlights the importance of closely monitoring and managing drug dosage adjustments,preventing and treating infections,addressing septic shock,paying attention to the prevention and control of ventilator-associated pneumonia(VAP),conducting timely psychological evaluations,and providing interventions during the treatment process for AOPP.
