RESUMO
BACKGROUND: Organophosphorus compounds (OP) are a group of substances used in agriculture as pesticides and are also used as military poisoning agents (MPA). Intoxication by these agents may cause severe systemic disturbances related to both the exposure time and lethal agent concentration. Toxic effects result from an excess of the endogenous neurotransmitter, acetylcholine (ACh), because decomposition of Ach by cholinesterases is blocked by OP. CASE REPORT: The authors describe a case in which an acute OP poisoning was managed both conventionally and with cholinesterase substitution by blood transfusion. CONCLUSIONS: Whole blood transfusion could be beneficial in the treatment of these life-threatening medical conditions.
Assuntos
Transfusão de Sangue , Intoxicação por Organofosfatos , Adolescente , Colinesterases/metabolismo , Humanos , Masculino , Paration/intoxicação , Praguicidas/intoxicaçãoRESUMO
A 16-year-old woman with craniofacial injury developed severe acute respiratory failure under the primary reconstructive surgical procedure requiring several units of blood and plasma. A transfusion related acute lung injury (TRALI) was suspected and supportive treatment was initiated. Because of the severity of symptoms, acute extracorporeal membrane oxygenation (ECMO) was planned. During preparation for ECMO, a single intravenous dose, 1 g of tranexamic acid, was administered and a remarkable improvement was observed shortly thereafter. The patient was placed on ECMO for 16 hours. The further course was uncomplicated and the patient was discharged from ICU on the 6th day after admission fully and she recovered. A clinical improvement was observed in a timely fashion following the administration of tranexamic acid. The handling of a suspected TRALI and potential benefit from administration of tranexamic acid are discussed in this case report.