Successful treatment of 4 patients with severe acute organic fluorine poisoning using extracorporeal membrane oxygenation
10.3760/cma.j.issn.1671-0282.2022.02.015
- VernacularTitle:体外膜氧合成功救治重度有机氟中毒4例报道
- Author:
Feng WU
1
;
Qiulin YANG
;
Xiaowen ZHANG
;
Yuying XU
;
Xiaojun LIU
;
Binbin WU
;
Yuezhen LIU
Author Information
1. 浙江衢化医院重症医学科，衢州 324004
- Keywords:
Poisoning;
Organic fluorine gas;
Acute respiratory failure;
Extracorporeal membrane oxygenation;
Complication;
Public health emergencies
- From:
Chinese Journal of Emergency Medicine
2022;31(2):223-227
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical experience of treating patients with severe acute organic fluorine poisoning using extracorporeal membrane oxygenation (ECMO).Methods:In January 2021, an acute mass organic fluorine gas poisoning incident occurred in Quzhou, Zhejiang Province. The clinical data of 4 severe patients with acute poisoning of organic fluorine treated by ECMO in our hospital were retrospectively analyzed, and the epidemiological characteristics, clinical symptoms, signs, the abnormal laboratory studies/examinations, and treatments of this kind poisoning patients, especially, the treatment pattern, support time, complications, and outcomes of ECMO were collected and analyzed.Results:All the 4 patients were male, with an average age of (52±9) years, and all of them came to the emergency department complaining chest tightness, cough and pharyngeal discomfort 6 h after exposure by inhalation. The patient’s condition progressed rapidly with severe acute respiratory failure and circulatory failure as the prominent manifestations. The mechanical ventilations were performed (13.0±4.8) h after poisoning, and ECMO treatment was performed (15.5±5.3) h after poisoning. Among them, 2 patients were treated using venoarterial (VA) ECMO, and 2 patients using venovenous (VV) ECMO, but 1 patient was converted to VA-ECMO 8 h later. The duration of ECMO support for the patients was (8.8±3.6) d. The duration of mechanical ventilation was (23.0±28.7) d and stay in intensive care unit was (42.0±55.4) d. Among them, one patient was transferred to a specialized rehabilitation hospital after the amputation surgery due to lower limb necrosis after VA-ECMO support, and the remaining 3 patients were discharged after recovery.Conclusions:ECMO support might have the irreplaceable value in the treatment of patients with severe acute organic fluorine poisoning, and should be considered as one of the reserves of regional health care system in dealing with public health emergencies.
