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Life-threatening hyponatremia due to intravenous n-acetylcysteine treatment in an infant: a case report

INTRODUCTION: N-acetylcysteine has proven to be effective in paracetamol intoxications, but there is no consensus regarding its way of administration. Here, we report a case to highlight the importance of careful management of intravenous n-acetylcysteine. CASE PRESENTATION: A two-month old infant w...

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Autores principales: Mayordomo-Colunga, Juan, Larrea, Elene, García, Mónica, Suárez, Sonsoles, Rodríguez, Julián
Formato: Texto
Lenguaje:English
Publicado: Cases Network Ltd 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769431/
https://www.ncbi.nlm.nih.gov/pubmed/19918421
http://dx.doi.org/10.4076/1757-1626-2-8347
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author Mayordomo-Colunga, Juan
Larrea, Elene
García, Mónica
Suárez, Sonsoles
Rodríguez, Julián
author_facet Mayordomo-Colunga, Juan
Larrea, Elene
García, Mónica
Suárez, Sonsoles
Rodríguez, Julián
author_sort Mayordomo-Colunga, Juan
collection PubMed
description INTRODUCTION: N-acetylcysteine has proven to be effective in paracetamol intoxications, but there is no consensus regarding its way of administration. Here, we report a case to highlight the importance of careful management of intravenous n-acetylcysteine. CASE PRESENTATION: A two-month old infant was seen in our paediatric emergency department due to paracetamol poisoning after repeated supratherapeutic doses. She was treated with intravenous n-acetylcysteine diluted with dextrose 5%, according to the 20-hour standard protocol. Eight hours later she developed two tonic-clonic seizures and was subsequently intubated. By that time, she had received almost 1 liter of 5% dextrose, and serum sodium was 114 mg/dL. A rapid correction was done with hypertonic saline and the child experienced a good outcome, without any sequelae. CONCLUSION: Intravenous n-acetylcysteine administration must be done carefully. Amount of liquid administrated and sodium monitoring should be kept in mind, with special care in small children.
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spelling pubmed-27694312009-11-16 Life-threatening hyponatremia due to intravenous n-acetylcysteine treatment in an infant: a case report Mayordomo-Colunga, Juan Larrea, Elene García, Mónica Suárez, Sonsoles Rodríguez, Julián Cases J Case report INTRODUCTION: N-acetylcysteine has proven to be effective in paracetamol intoxications, but there is no consensus regarding its way of administration. Here, we report a case to highlight the importance of careful management of intravenous n-acetylcysteine. CASE PRESENTATION: A two-month old infant was seen in our paediatric emergency department due to paracetamol poisoning after repeated supratherapeutic doses. She was treated with intravenous n-acetylcysteine diluted with dextrose 5%, according to the 20-hour standard protocol. Eight hours later she developed two tonic-clonic seizures and was subsequently intubated. By that time, she had received almost 1 liter of 5% dextrose, and serum sodium was 114 mg/dL. A rapid correction was done with hypertonic saline and the child experienced a good outcome, without any sequelae. CONCLUSION: Intravenous n-acetylcysteine administration must be done carefully. Amount of liquid administrated and sodium monitoring should be kept in mind, with special care in small children. Cases Network Ltd 2009-09-01 /pmc/articles/PMC2769431/ /pubmed/19918421 http://dx.doi.org/10.4076/1757-1626-2-8347 Text en © 2009 Mayordomo-Colunga et al.; licensee Cases Network Ltd. http://creativecommons.org/licenses/by/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case report
Mayordomo-Colunga, Juan
Larrea, Elene
García, Mónica
Suárez, Sonsoles
Rodríguez, Julián
Life-threatening hyponatremia due to intravenous n-acetylcysteine treatment in an infant: a case report
title Life-threatening hyponatremia due to intravenous n-acetylcysteine treatment in an infant: a case report
title_full Life-threatening hyponatremia due to intravenous n-acetylcysteine treatment in an infant: a case report
title_fullStr Life-threatening hyponatremia due to intravenous n-acetylcysteine treatment in an infant: a case report
title_full_unstemmed Life-threatening hyponatremia due to intravenous n-acetylcysteine treatment in an infant: a case report
title_short Life-threatening hyponatremia due to intravenous n-acetylcysteine treatment in an infant: a case report
title_sort life-threatening hyponatremia due to intravenous n-acetylcysteine treatment in an infant: a case report
topic Case report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769431/
https://www.ncbi.nlm.nih.gov/pubmed/19918421
http://dx.doi.org/10.4076/1757-1626-2-8347
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