Acute renal failure from organophospate poisoning: a case of success with haemofiltration.
Severe organophosphate poisoning (OPP) has a high mortality rate. Respiratory and neurological complications are common in OPP. Multiple organ distress syndrome (MODS) and renal impairment are relatively rare but correlated with death. In previous publications, in patients who did not survive OPP, their deaths were due to MODS or acute renal failure. A case of intentional ingestion of an organophosphate with renal and multiple organ complications is described. In addition to the standard atropine/oxime regimen, continuous venous-venous haemofiltration (CVVH) therapy was started; the patient survived this intoxication. The pathogenesis of renal injury by OPP is unclear and more insight is required. In our experience, CVVH can be a valid therapy, considering in particular the toxicokinetics of the organophosphate.
Anaesthesia and Intensive Care Unit, Azienda ULSS 8, City Hospital, Via Montegrappa 34, 31044 Montebelluna (TV), Italy.
Moreno
M
Agostini
Andrea
A
Bianchin
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy*; D000328:Adult; D000931:Antidotes / Q000627:therapeutic use; D001285:Atropine / Q000627:therapeutic use; D006440:Hemofiltration; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D008297:Male; D009946:Organothiophosphorus Compounds / Q000506:poisoning*; D011220:Pralidoxime Compounds / Q000627:therapeutic use; D013406:Suicide, Attempted; D016896:Treatment Outcome
D000931:Antidotes; D007306:Insecticides; D009946:Organothiophosphorus Compounds; D011220:Pralidoxime Compounds; D001285:Atropine; C014655:methamidophos; C028797:pralidoxime