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Favorable Outcome of Severe Acute Methadone Poisoning (Clinical Case)

https://doi.org/10.15360/1813-9779-2018-5-25-31

Abstract

Purpose: to contribute to relief of metabolic disorders associated with hypoxia by including a succinate correcting tissue metabolism into the scheme of intensive care of acute severe methadone poisoning complicated by the crush syndrome.

Materials and methods. We examined the dynamics of clinical manifestation of acute methadone poisoning complicated by crush syndrome: changes in clinical and biochemical parameters, coagulation test findings, blood gas composition and acid-base state, ECG and X-ray findings.

Results. By the 7th day after patient's admission in the ICU, stabilization of hemodynamics, recovery of spontaneous breathing and consciousness, reduction of swelling and the beginning of the formation of pressure ulcers were observed; on the 8 the day, restoration of urination and characteristics of urine were registered. On the 12th day, the patient was transferred to the toxicology unit being in a state of moderate severity and demonstrating positive changes in all clinical parameters.

Conclusion. The inclusion of a drug with antioxidant/antihypoxant properties in the infusion therapy scheme allows to relieve metabolic disorders associated with hypoxia, and thereby increase the effectiveness of treatment: i.e. to relief clinical and laboratory manifestations and reduce the ICU stay.

About the Authors

G. A. Livanov
I. I. Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine
Russian Federation

Georgy A. Livanov

3 Budapeshtskaya Str., 192242 Saint-Petersburg




A. N. Lodyagin
I. I. Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine
Russian Federation

Alexey N. Lodyagin

3 Budapeshtskaya Str., 192242 Saint-Petersburg




A. А. Razina
I. I. Mechnikov North-Western State Medical University, Ministry of Health of Russia
Russian Federation

Anna A. Razina

47 Piskarevskii prospect, 195067 St. Petersburg




S. I. Glushkov
I. I. Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine
Russian Federation

Sergey I. Glushkov

3 Budapeshtskaya Str., 192242 Saint-Petersburg




A. A. Ivanova
I. I. Mechnikov North-Western State Medical University, Ministry of Health of Russia
Russian Federation

Alexandra A. Ivanova

47 Piskarevskii prospect, 195067 St. Petersburg




E. V. Volchkova
I. P. Pavlov First Saint-Petersburg State Medical University, Ministry of Health of Russia
Russian Federation

Elizabeth V. Volchkova

6–8 Lev Tolstoy Str., 197022 St. Petersburg




B. V. Batotsyrenov
I. I. Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine
Russian Federation

Bair V. Batotsyrenov

3 Budapeshtskaya Str., 192242 Saint-Petersburg




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Review

For citations:


Livanov G.A., Lodyagin A.N., Razina A.А., Glushkov S.I., Ivanova A.A., Volchkova E.V., Batotsyrenov B.V. Favorable Outcome of Severe Acute Methadone Poisoning (Clinical Case). General Reanimatology. 2018;14(5):25-31. https://doi.org/10.15360/1813-9779-2018-5-25-31

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ISSN 1813-9779 (Print)
ISSN 2411-7110 (Online)