title: Refractory cardiopulmonary failure after glyphosate surfactant intoxication: a case report.
abstract: BACKGROUND
  Glyphosate is an herbicide considered to be of low toxicity to humans because its effects are specific to plants. However, fatal reactions to glyphosate have been reported after the ingestion of large amounts. Pulmonary edema, shock, and arrhythmia were the reported causes of mortality.
  
  
  METHODS
  We present the case of a 57-year-old woman who was admitted to the emergency department unconsciousness after ingestion of glyphosate surfactant in a suicide attempt. Metabolic acidosis, refractory respiratory failure, and shock developed during hospitalization. Despite aggressive supportive care, the patient died in the hospital.
  
  
  CONCLUSIONS
  The toxicokinetics of glyphosate surfactant is complicated. Respiratory failure, metabolic acidosis, tachycardia, elevated creatinine, and hyperkalemia are poor prognostic factors if presented. Physicians should consider using hemodialysis early to improve the outcome of patients with glyphosate surfactant intoxication.
authors.affiliation: Nephrology Division, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan. 27509@cch.org.tw.
authors.forename: Chirn-Bin
authors.initials: CB
authors.lastname: Chang
authors.forename: Chia-Chu
authors.initials: CC
authors.lastname: Chang