Fatal intoxication due to tramadol alone: case report and review of the literature.
Poisoning may also lead to both coma and multiple organ failure, also in youngsters without a known major medical history. As not all toxic agents are routinely screened when a poisoning is suspected, it is useful to consider less frequently encountered poisons in certain cases. We describe the occurrence of asystole and multiple organ failure which occurred in a young man after a suspected tramadol overdose. The tramadol concentration on admission in the ICU was indeed 8 microg/ml (mg/l), far above the therapeutic range. Subsequently, the patient developed severe acute liver failure, finally leading to death. Post-mortem toxicology did not reveal any other poison responsible for this unfavourable course as only very high serum and tissue tramadol and desmethyltramadol concentrations were found. Only a few fatal poisonings attributable to tramadol alone, as observed in our case, have been reported. An overview of these cases is presented.
De Decker
Koen
K
Department of Critical Care Medicine, University Hospital of Antwerp, Edegem, Belgium. koen.de.decker@uza.be
Cordonnier
Jan
J
Jacobs
Werner
W
Coucke
Vera
V
Schepens
Paul
P
Jorens
Philippe G
PG
D000328:Adult; D000701:Analgesics, Opioid / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D062787:Drug Overdose; D053593:Forensic Toxicology; D006323:Heart Arrest / Q000139:chemically induced; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000139:chemically induced; D014018:Tissue Distribution; D014147:Tramadol / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*
D000701:Analgesics, Opioid; D014147:Tramadol