The Korean Journal of Critical Care Medicine  2011;26(3):177-180

doi:10.4266/kjccm.2011.26.3.177

A Case of Acute on Chronic Salicylate Poisoned Elderly Patient with Early Utilization of Continuous Venovenous Hemodiafiltration: A Case Report.

Ji Sook LEE 1 ; Woo Chan JEON ; Young Gi MIN ; Won Hyun RYU ; Yoon Seok JUNG ; Sang Cheon CHOI

Affiliations

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Keywords

continuous venovenous hemodiafiltration (CVVHDF); elderly; poisoning; salicylate

Country

Republic of Korea

Language

Korean

Abstract

Salicylate poisonings are divided into acute and chronic syndromes. The most challenging aspect of the management of aspirin-poisoning may be recognition of subtle signs and symptoms of chronic, unintentional overdose. Chronic poisoning typically occurs in elderly as a result of unintentional overdosing on salicylates used to treat chronic conditions. Treatment is directed toward preventing intestinal absorption of the drugs and enhanced elimination. After the first-line treatments, aspirin overdose with its complications of hemodynamic, electrolyte and acid-base issues, is best managed by prompt hemodialysis. We report a case of a 87-year-old woman, who presented with acute on chronic salicylate poisoning. After early continuous venovenous hemodiafiltration, old woman made a good recovery from the salicylism but suffered paralytic ileus caused by aspirin enteroliths. Physician can decide a prompt hemodialysis for salicylate-poisoned patients, who worsen clinical courses despite of first-line therapies.