Glufosinate ammonium is the active ingredient in broad-spectrum contact herbicides such as BASTA(R) that inhibits the activity of glutamine synthetase, which is necessary for the production of the amino acid glutamine and for ammonia detoxification. Complications of glufosinate ammonium intoxication include gastrointestinal symptoms, loss of consciousness, convulsions, memory impairment, respiratory failure, and cardiovascular instability. We report herein a case of encephalopathy and reversible signal changes in the splenium of the corpus callosum, the bilateral corticospinal tracts, the hippocampi, and the cerebellar peduncles as seen in diffusion-weighted magnetic resonance imaging and fluid-attenuated inversion recovery images following BASTA(R) intoxication.
Ammonia ; Ammonium Compounds* ; Corpus Callosum ; Glutamate-Ammonia Ligase ; Glutamine ; Herbicides ; Magnetic Resonance Imaging ; Memory ; Pyramidal Tracts ; Respiratory Insufficiency ; Seizures ; Unconsciousness

Objective: Arterial blood gas analysis (ABGA) is routinely performed in hyperventilation syndrome (HVS) patients in the emergency department (ED). We tried to substitute end-tidal carbon dioxide (ETCO2) for arterial partial pressure of carbon dioxide (PaCO2) in HVS patients in ED. Methods: It was a prospective observational cohort study of HVS patients from May 2019 to March 2020. Data of age, sex, vital sign, ETCO2 and ABGA were collected. We compared the Pearson correlation between ETCO2 and PaCO2. Results: A total of 135 HVS patients were included in the study. The average value for ETCO2 was 24.9±7.2. It showed a significant linear between ETCO2 and PaCO2. The Pearson correlation coefficient was 0.893 (P<0.001). The linear correlation coefficients of ETCO2 <20 mmHg and ETCO2 20-35 mmHg groups were 0.513 and 0.827, respectively (P<0.001). Conclusion We suggest that ABGA can be replaced by ETCO2 in HVS patients in ED.