Citation

Liu Y, Liu B, Zhou H, Wei LQ. Am. J. Med. Sci. 2012; 344(2): 166-170.

Copyright

(Copyright © 2012, Lippincott Williams and Wilkins)

DOI

10.1097/MAJ.0b013e318254490d

PMID

unavailable

Abstract

Respiratory failure is the leading cause of death after organophosphorus poisoning. Cardiac complications are rare, serious and little known to clinicians. The authors present a case of a 74-year-old man with refractory cardiogenic shock after taking 200 mL of 80% dichlorvos for a suicide attempt. This study represents the first reported cardiogenic shock resulting from organophosphorus poisoning in the literature, clarifying its hemodynamic features with invasive hemodynamic monitoring (PiCCO; Pulsion Medical Systems AG, Munich, Germany). Additional levosimendan infusion was commenced after insufficient conventional therapies, resulting in an increase in cardiac power index by 236% and a decrease in systemic vascular resistance by 69% after 24 hours of continuous infusion. Despite the immense hemodynamic improvement after levosimendan treatment, the patient died of multiple organ failure 6 days after admission. The authors also discussed the inotropic and vasodilatory effects of levosimendan in this clinical scenario. © 2012 Lippincott Williams & Wilkins.

Language: en

Keywords

human; male; multiple organ failure; aged; case report; liver failure; dichlorvos; mortality; suicide attempt; kidney failure; acetylcholinesterase; Cardiogenic shock; article; drug intoxication; stomach lavage; noradrenalin; dopamine; activated carbon; drug withdrawal; artificial ventilation; atropine; intravenous administration; hematologic disease; respiratory failure; low drug dose; dobutamine; Organophosphorus poisoning; drug dose reduction; continuous infusion; cardiogenic shock; loading drug dose; pralidoxime chloride; Multiple organ failure; Calcium sensitizer; levosimendan; Thermodilution