Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20822
Full metadata record
DC FieldValueLanguage
dc.contributor.authorWong, Anselm-
dc.contributor.authorTong, Roger L K-
dc.contributor.authorRyan, Liam-
dc.contributor.authorCrozier, Tim-
dc.contributor.authorGraudins, Andis-
dc.date2017-08-16-
dc.date.accessioned2019-05-17T00:25:37Z-
dc.date.available2019-05-17T00:25:37Z-
dc.date.issued2019-03-
dc.identifier.citationClinical Toxicology 2018; 56(3): 229-231en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/20822-
dc.description.abstractMassive paracetamol ingestion causing mitochondrial dysfunction is uncommon. Use of sustained low-efficiency dialysis (SLED) to improve acidaemia and enhance paracetamol elimination has not been previously described. A 44-year-old male presented to the emergency department 2.5 hours post overdose of 200 g (2.5 g/kg) of paracetamol. Examination revealed a BP 85/60 mmHg, pulse 112 bpm, temperature 33.9 °C and blood glucose of 13.9 mmol/l. Venous blood gas 5.5-hours post-ingestion showed a pH 6.9, pCO2 58 mmHg, HCO3 13 mmol/l and lactate 14 mmol/l. Fifty-grams of nasogastric activated charcoal and double-strength intravenous acetylcysteine were administered. Paracetamol concentration peaked at 4207 µmol/l six hours post-ingestion. SLED was commenced nine-hours post ingestion and acetylcysteine dose was doubled again during dialysis. Paracetamol extraction ratio was 47-52%. Plasma paracetamol clearance was steady throughout SLED (53-58 ml/min). Hepatotoxicity did not develop and the patient recovered. Intermittent hemodialysis (IHD) is more efficient than SLED or continuous renal replacement therapy for enhancing paracetamol elimination and clearance. IHD plasma clearance is reported to range from 36 to 215 ml/min compared with endogenous clearance of 224 ml/70 kg/min. SLED improved acidaemia with only moderate overall increase in paracetamol plasma clearance. Lack of development of hepatotoxicity was likely the result of early administration of acetylcysteine rather than any effect of SLED on paracetamol elimination.en_US
dc.language.isoeng-
dc.subjectParacetamolen_US
dc.subjectdialysisen_US
dc.subjectmetabolicen_US
dc.titleThe use of sustained low efficiency dialysis (SLED) in massive paracetamol overdose.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleClinical Toxicology (Philadelphia, Pa.)en_US
dc.identifier.affiliationMonash Toxicology Service, Program of Emergency Medicine, Monash Health, Melbourne, Australiaen_US
dc.identifier.affiliationMonash Emergency Research Collaboration, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australiaen_US
dc.identifier.affiliationToxicologyen_US
dc.identifier.affiliationIntensive Care Department, Monash Health, Clayton, Australiaen_US
dc.identifier.doi10.1080/15563650.2017.1358366en_US
dc.type.contentTexten_US
dc.identifier.orcid0000-0002-6817-7289en_US
dc.identifier.pubmedid28812394-
dc.type.austinCase Reports-
dc.type.austinJournal Article-
local.name.researcherGraudins, Andis
item.fulltextNo Fulltext-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.languageiso639-1en-
item.openairetypeJournal Article-
item.grantfulltextnone-
item.cerifentitytypePublications-
crisitem.author.deptToxicology-
crisitem.author.deptEmergency-
crisitem.author.deptVictorian Poisons Information Centre-
crisitem.author.deptVictorian Poisons Information Centre-
Appears in Collections:Journal articles
Show simple item record

Page view(s)

40
checked on May 26, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.