Cardiac arrest due to baclofen withdrawal syndrome.
BMJ Case Rep
; 20142014 May 14.
Article
em En
| MEDLINE
| ID: mdl-24827663
ABSTRACT
A 41-year-old man presented with postcervical traumatic complete quadriparesis under intrathecal baclofen therapy (ITB) for refractory spasticity. Less than 24 h after having his baclofen pump substituted, he develops hyperthermia, seizures, cognitive depression, acute hypoxaemic respiratory failure and cardiovascular instability leading to mechanical ventilation and vasopressor support. He was transferred to an intensive care unit with diagnosis of community-acquired pneumonia leading to septic shock. He evolved with progressive clinical worsening and multisystem organ failure and cardiac arrest in non-shockable rhythm (pulseless electrical activity)--4 min resuscitation with return of spontaneous circulation. Considering the possible diagnosis of baclofen withdrawal syndrome and, in suspicion of ITB delivery disruption, the catheter system was surgically explored and a leaking tubule attachment was found. Despite aggressive cardiovascular, respiratory and renal support therapy, clinical improvement occurred only after restoration of intrathecal drug delivery. He was discharged from the hospital after 56 days, having returned to baseline status.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Quadriplegia
/
Síndrome de Abstinência a Substâncias
/
Baclofeno
/
Injeções Espinhais
/
Falha de Equipamento
/
Parada Cardíaca
/
Espasticidade Muscular
Limite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
BMJ Case Rep
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Portugal