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Korean J Crit Care Med > Volume 26(3); 2011 > Article
Korean Journal of Critical Care Medicine 2011;26(3): 177-180. doi: https://doi.org/10.4266/kjccm.2011.26.3.177
조기 연속정맥정맥간혈액투석여과로 치료한 노인 환자의 급만성 아스피린 중독 -증례 보고-
이지숙ㆍ전우찬ㆍ민영기ㆍ류원현ㆍ정윤석ㆍ최상천
아주대학교 의과대학 응급의학교실
A Case of Acute on Chronic Salicylate Poisoned Elderly Patient with Early Utilization of Continuous Venovenous Hemodiafiltration: A Case Report
Ji Sook Lee, Woo Chan Jeon, Young Gi Min, Won Hyun Ryu, Yoon Seok Jung, Sang Cheon Choi
Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea. avenue59@ajou.ac.kr
ABSTRACT
Salicylate poisonings are divided into acute and chronic syndromes. The most challenging aspect of the management of aspirin-poisoning may be recognition of subtle signs and symptoms of chronic, unintentional overdose. Chronic poisoning typically occurs in elderly as a result of unintentional overdosing on salicylates used to treat chronic conditions. Treatment is directed toward preventing intestinal absorption of the drugs and enhanced elimination. After the first-line treatments, aspirin overdose with its complications of hemodynamic, electrolyte and acid-base issues, is best managed by prompt hemodialysis. We report a case of a 87-year-old woman, who presented with acute on chronic salicylate poisoning. After early continuous venovenous hemodiafiltration, old woman made a good recovery from the salicylism but suffered paralytic ileus caused by aspirin enteroliths. Physician can decide a prompt hemodialysis for salicylate-poisoned patients, who worsen clinical courses despite of first-line therapies.
Key Words: continuous venovenous hemodiafiltration (CVVHDF); elderly; poisoning; salicylate
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