title: Barium carbonate intoxication.
abstract: A 22-year-old man attempted to commit suicide by swallowing an unknown amount of barium carbonate dissolved in hydrochloric acid. Shortly after ingestion, he developed crampy abdominal pain and generalized muscle weakness. About 2 h later, respiratory failure ensued necessitating orotracheal intubation and mechanical ventilation. Concomitantly, life-threatening arrhythmias including ventricular fibrillation occurred, and he had to be resuscitated for 45 min. After correction of severe hypokalemia (serum potassium 1.5 mmol/l), cardiac rhythm stabilized. In an attempt to accelerate removal of barium from the circulation hemodialysis was begun. During hemodialysis muscle strength returned. Pharmacokinetic analysis of serum barium levels suggest that hemodialysis shortened the serum half-life of barium. Subsequently, the patient made a complete and uneventful recovery. Our case demonstrates that severe barium poisoning can be survived provided that early aggressive therapeutic measures are undertaken. Hemodialysis seems to be efficacious in the therapy of barium intoxication.
authors.affiliation: Department of Internal Medicine, Medical School Hannover, Federal Republic of Germany.
authors.forename: T F
authors.initials: TF
authors.lastname: Schorn
authors.forename: C
authors.initials: C
authors.lastname: Olbricht
authors.forename: A
authors.initials: A
authors.lastname: Schüler
authors.forename: A
authors.initials: A
authors.lastname: Franz
authors.forename: K
authors.initials: K
authors.lastname: Wittek
authors.forename: H J
authors.initials: HJ
authors.lastname: Balks
authors.forename: E
authors.initials: E
authors.lastname: Hausmann
authors.forename: H H
authors.initials: HH
authors.lastname: Wellhoener
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000628:therapy; D001464:Barium / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D002254:Carbonates; D004630:Emergencies; D006801:Humans; D007008:Hypokalemia / Q000097:blood / Q000209:etiology / Q000628:therapy; D008297:Male; D011041:Poisoning / Q000097:blood / Q000150:complications / Q000628:therapy*; D006435:Renal Dialysis; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D013406:Suicide, Attempted
chemical_list: D002254:Carbonates; D001464:Barium; C006685:barium carbonate