title: Continuous renal replacement therapy circuit failure after antidote administration.
abstract: A 73-year-old man was transferred to the emergency department (ED). He was found unconscious in his house along with an empty 200-mL bottle of Basta(™), a herbicide containing 18% glufosinate. He was comatose with a Glasgow Coma Scale score of 3. As his blood pressure dropped to 60/30 mmHg despite fluids and norepinephrine, 20% intravenous fat emulsion product was injected. He experienced repeated cardiopulmonary arrests during his first 4 h in the ED. When the arrests occurred, standard cardiopulmonary resuscitation was performed, and boluses of fat emulsion were given. He was given a total of 1500 mL of 20% fat emulsion. In an attempt to correct the acidosis, continuous renal replacement therapy (CRRT) was started. Within 5 min of starting CRRT, the transmembrane pressure increased sharply and the machine stopped.
authors.affiliation: Department of Emergency Medicine, College of Medicine, Dong-A University , Seo-Gu, Busan , Republic of Korea.
authors.forename: Jinwoo
authors.initials: J
authors.lastname: Jeong
mesh_terms: D000368:Aged; D000613:Aminobutyrates / Q000506:poisoning*; D000931:Antidotes / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D062787:Drug Overdose / Q000175:diagnosis / Q000628:therapy*; D004868:Equipment Failure; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D017809:Fatal Outcome; D015600:Glasgow Coma Scale; D006540:Herbicides / Q000506:poisoning*; D006801:Humans; D007688:Kidneys, Artificial; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation*; D013406:Suicide, Attempted; D013997:Time Factors
chemical_list: D000613:Aminobutyrates; D000931:Antidotes; D005217:Fat Emulsions, Intravenous; D006540:Herbicides; C003121:phosphinothricin
keywords: Acidosis; Continuous renal replacement therapy; Fat emulsion; Herbicide