Intoxication by large amounts of barium nitrate overcome by early massive K supplementation and oral administration of magnesium sulphate.
Suicide by ingestion of barium is exceptionally rare. Adverse health effects depend on the solubility of the barium compound. Severe hypokalemia, which generally occurs within 2 hours after ingestion, is the predominating feature of acute barium toxicity, subsequently leading to adverse effects on muscular activity and cardiac automaticity. We report one case of acute poisoning with barium nitrate, a soluble barium compound. A 75-year-old woman was hospitalized after suicidal ingestion of a burrow mole fumigant containing 12.375 g of barium nitrate. About 1 hour post-ingestion, she was only complaining of abdominal pain. The ECG recording demonstrated polymorphic ventricular premature complexes (VPCs). Laboratory data revealed profound hypokalemia (2.1 mmol/L). She made a complete and uneventful recovery after early and massive potassium supplementation combined with oral magnesium sulphate to prevent barium nitrate absorption.
Payen
Christine
C
Poison Center and Pharmacovigilance Department, Lyon University Hospitals, 162 avenue Lacassagne, Lyon cedex 03, France. christine.payen@chu-lyon.fr
Dellinger
Arnaud
A
Pulce
Corine
C
Cirimele
Vincent
V
Carbonnel
Vincent
V
Kintz
Pascal
P
Descotes
Jacques
J
D000341:Affective Disorders, Psychotic / Q000523:psychology; D000368:Aged; D017609:Barium Compounds / Q000037:antagonists & inhibitors / Q000506:poisoning*; D011232:Chemical Precipitation; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy*; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D009566:Nitrates / Q000037:antagonists & inhibitors / Q000506:poisoning; D011188:Potassium / Q000097:blood / Q000627:therapeutic use*; D012378:Rodenticides / Q000037:antagonists & inhibitors / Q000506:poisoning*; D012720:Severity of Illness Index; D013406:Suicide, Attempted; D016896:Treatment Outcome
D017609:Barium Compounds; D009566:Nitrates; D012378:Rodenticides; D008278:Magnesium Sulfate; C023545:barium nitrate; D011188:Potassium