Rodentisit (fare zehiri) ve etilen glikol (antifriz) ile intihar girişimi

Abstract

Intoxications with drugs or chemicals are frequent and may be fatal. Although rodenticide intoxication is common in our country, Ethyleneglycol (EG) intoxication is very rarely seen. Fourty nine-year-old male was admitted to ICU with rastbane intoxication diagnosis. Unconscious patient was intubated. Despite 45 min-1respiratory rate, vital signs were stable. After deep metabolic asidosis in ABG, NaHCO3 infusion was started. As clinic presentation didn't match with rotentisit intoxication, more detailed anamnes was taken and antifreeze intake was detected. After bolus dose, 45% ethylalcohol infusion was applied via nasogastric tube. At 4th hour, haemodialysis was performed. As coagulation deteriorated, vitamine K and FFP was administered. After 16th hour, patient was unuric and taken to daily haemodialysis programme. At 21th hour, therapy continued by 0.83 mL kg-1 hr-110% ethanol intravenously. Daily vitamine K, thiamine, pyridoxine, folicacid and calcium gluconate replacements were applied. Metabolic asidosis recovered at 4th day and then he was extubated. On the 10th day, haemodialysis need ended and he was discharged home. EG intoxication is rarely seen and known poorly in our country. Deep metabolic asidosis is detected in the unconscious patient. Diabetic and alcoholic ketoasidosis, uremia, lactic asidosis, ASA and methanol intoxications should be kept in mind at differencial diagnosis. The main therapy includes NaHCO3, ethanol, haemodialysis and specific antidote fomepizole. At rodenticide intoxication, parenteral vitamine K and FFP administrations play an important role on mortality. In conclusion, early recognition and therapy have vital importance in intoxication cases. If toxicagent doesn't match with clinic presentation, anamnesis should be questioned again carefully.