Citation

Mongenot F, Gonthier YT, Derderian F, Durand M, Blin D. Ann. Fr. Anesth. Reanim. 2007; 26(2): 164-167.

Copyright

(Copyright © 2007, Elsevier Publishing)

DOI

10.1016/j.annfar.2006.09.005

PMID

17092685

Abstract

We report a case of massive overdose of hydroxychloroquine treated with circulatory assistance by peripheral extracorporeal circulation (ECC). We expose the case of a 39-year-old woman who ingested 12 g of hydroxychloroquine with bromazepam, paroxetine, and zolpidem, in a suicide attempt. Patient has developed central nervous system depression, hemodynamic failure, life-threatening ventricular arrhythmias, and serious hypokalemia. Initially the patient has received conventional treatment with gastric lavage and activated charcoal for gastrointestinal decontamination, blood volume expansion and vasopressive drugs, intubation and mechanical ventilation, high dose of diazepam, and potassium replacement. A ventricular fibrillation was treated with external cardiac massage. In spite of this treatment, cardiogenic shock was uncontrolled, and imposed circulatory assistance. After extracorporeal circulation, we observed a spectacular improvement of hemodynamic parameters and electrocardiographic normalization at day one. Extracorporeal circulation could be used as a rescue treatment of cardiotrope and hydroxychloroquine overdoses.

Language: fr

Keywords

Adult; Antidotes; Bromazepam; Charcoal; Coma; Combined Modality Therapy; Diazepam; Drug Overdose; Epinephrine; Extracorporeal Circulation; Female; Fluid Therapy; Gastric Lavage; Heart Massage; Humans; Hydroxychloroquine; Hypokalemia; Paroxetine; Plasma Substitutes; Potassium; Pyridines; Shock, Cardiogenic; Sodium Channel Blockers; Suicide, Attempted; Vasoconstrictor Agents; Ventricular Fibrillation; Zolpidem