[Treatment of hydroxychloroquine poisoning with extracorporeal circulation].
We report a case of massive overdose of hydroxychloroquine treated with circulatory assistance by peripheral extracorporeal circulation (ECC). We expose the case of a 39-year-old woman who ingested 12 g of hydroxychloroquine with bromazepam, paroxetine, and zolpidem, in a suicide attempt. Patient has developed central nervous system depression, hemodynamic failure, life-threatening ventricular arrhythmias, and serious hypokalemia. Initially the patient has received conventional treatment with gastric lavage and activated charcoal for gastrointestinal decontamination, blood volume expansion and vasopressive drugs, intubation and mechanical ventilation, high dose of diazepam, and potassium replacement. A ventricular fibrillation was treated with external cardiac massage. In spite of this treatment, cardiogenic shock was uncontrolled, and imposed circulatory assistance. After extracorporeal circulation, we observed a spectacular improvement of hemodynamic parameters and electrocardiographic normalization at day one. Extracorporeal circulation could be used as a rescue treatment of cardiotrope and hydroxychloroquine overdoses.
Mongenot
F
F
Département d'anesthésie-réanimation cardiovasculaire et thoracique, hôpital Michallon, boulevard de la Chantourne, 38700 La Tronche, Grenoble, France. frederic.mongenot@gmail.com
Gonthier
Y Tessier
YT
Derderian
F
F
Durand
M
M
Blin
D
D
D000328:Adult; D000931:Antidotes / Q000627:therapeutic use; D001960:Bromazepam / Q000009:adverse effects; D002606:Charcoal / Q000627:therapeutic use; D003128:Coma / Q000139:chemically induced / Q000628:therapy; D003131:Combined Modality Therapy; D003975:Diazepam / Q000627:therapeutic use; D062787:Drug Overdose / Q000628:therapy; D004837:Epinephrine / Q000627:therapeutic use; D005112:Extracorporeal Circulation; D005260:Female; D005440:Fluid Therapy; D005751:Gastric Lavage; D006336:Heart Massage; D006801:Humans; D006886:Hydroxychloroquine / Q000097:blood / Q000506:poisoning*; D007008:Hypokalemia / Q000139:chemically induced / Q000188:drug therapy; D017374:Paroxetine / Q000009:adverse effects; D010952:Plasma Substitutes / Q000627:therapeutic use; D011188:Potassium / Q000627:therapeutic use; D011725:Pyridines / Q000009:adverse effects; D012770:Shock, Cardiogenic / Q000139:chemically induced / Q000628:therapy*; D026941:Sodium Channel Blockers / Q000506:poisoning*; D013406:Suicide, Attempted; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014693:Ventricular Fibrillation / Q000139:chemically induced / Q000628:therapy*; D000077334:Zolpidem
D000931:Antidotes; D010952:Plasma Substitutes; D011725:Pyridines; D026941:Sodium Channel Blockers; D014662:Vasoconstrictor Agents; D002606:Charcoal; D017374:Paroxetine; D006886:Hydroxychloroquine; D000077334:Zolpidem; D003975:Diazepam; D011188:Potassium; D001960:Bromazepam; D004837:Epinephrine