Plasmapheresis in the treatment of inadvertent intravenous infusion of an enteral feeding solution.
This 50-year-old man was on enteral full-strength Ensure through the jejunostomy tube. The enteral feed was accidentally infused through the peripheral intravenous line. He went into a septic state with hypotension, hypoxemia, and increased pulmonary shunting requiring ventilatory and inotropic support. We instituted two cycles of plasmapheresis in an attempt to remove any foreign antigen and toxins present. This resulted in improved oxygenation, rapid recovery, and discharge from intensive care. His blood culture grew Klebsiella species that was consistent with the organism grown from the culture of the Ensure feeds.
Ong
B C
BC
Department of Anaesthesia and Surgical Intensive Care, Singapore General Hospital, Singapore. ganobc@sgh.gov.sg
Soo
K C
KC
D004750:Enteral Nutrition; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis