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Continuous renal replacement therapy increased plasma cholinesterase activity in a case of acute organophosphate poisoning

Extracorporeal removal of organophosphate from blood has been proposed, but the efficacy of hemodialysis and hemoperfusion has not been established. We report a case of organophosphate poisoning in which continuous renal replacement therapy (CRRT) was applied with conventional indications and was fo...

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Autores principales: Kwon, In Ho, Jeong, Jinwoo, Choi, Yuri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Critical Care Medicine 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732211/
https://www.ncbi.nlm.nih.gov/pubmed/34510883
http://dx.doi.org/10.4266/acc.2021.00780
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author Kwon, In Ho
Jeong, Jinwoo
Choi, Yuri
author_facet Kwon, In Ho
Jeong, Jinwoo
Choi, Yuri
author_sort Kwon, In Ho
collection PubMed
description Extracorporeal removal of organophosphate from blood has been proposed, but the efficacy of hemodialysis and hemoperfusion has not been established. We report a case of organophosphate poisoning in which continuous renal replacement therapy (CRRT) was applied with conventional indications and was found to increase plasma cholinesterase levels by hemodiafiltration. A 73-year-old male was found unconscious at home and was brought to the emergency department by ambulance. An empty bottle of Supracide insecticide, of which the active ingredient is methidathion, was found beside him. CRRT was initiated because he showed signs of oliguria and acidosis with an unstable hemodynamic condition. Although his condition improved temporarily after CRRT initiation, it subsequently deteriorated, and he died despite maximal supportive effort. His prefilter plasma cholinesterase levels remained at <200 U/L for 3 days, while his postfilter levels were 358 U/L 1 hour after CRRT initiation and they were 689 U/L 18 hours later. Our case suggests that CRRT might play a role in treating organophosphate poisoning by possibly eliminating organophosphate.
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spelling pubmed-97322112022-12-19 Continuous renal replacement therapy increased plasma cholinesterase activity in a case of acute organophosphate poisoning Kwon, In Ho Jeong, Jinwoo Choi, Yuri Acute Crit Care Case Report Extracorporeal removal of organophosphate from blood has been proposed, but the efficacy of hemodialysis and hemoperfusion has not been established. We report a case of organophosphate poisoning in which continuous renal replacement therapy (CRRT) was applied with conventional indications and was found to increase plasma cholinesterase levels by hemodiafiltration. A 73-year-old male was found unconscious at home and was brought to the emergency department by ambulance. An empty bottle of Supracide insecticide, of which the active ingredient is methidathion, was found beside him. CRRT was initiated because he showed signs of oliguria and acidosis with an unstable hemodynamic condition. Although his condition improved temporarily after CRRT initiation, it subsequently deteriorated, and he died despite maximal supportive effort. His prefilter plasma cholinesterase levels remained at <200 U/L for 3 days, while his postfilter levels were 358 U/L 1 hour after CRRT initiation and they were 689 U/L 18 hours later. Our case suggests that CRRT might play a role in treating organophosphate poisoning by possibly eliminating organophosphate. Korean Society of Critical Care Medicine 2022-11 2021-11-16 /pmc/articles/PMC9732211/ /pubmed/34510883 http://dx.doi.org/10.4266/acc.2021.00780 Text en Copyright © 2021 The Korean Society of Critical Care Medicine https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kwon, In Ho
Jeong, Jinwoo
Choi, Yuri
Continuous renal replacement therapy increased plasma cholinesterase activity in a case of acute organophosphate poisoning
title Continuous renal replacement therapy increased plasma cholinesterase activity in a case of acute organophosphate poisoning
title_full Continuous renal replacement therapy increased plasma cholinesterase activity in a case of acute organophosphate poisoning
title_fullStr Continuous renal replacement therapy increased plasma cholinesterase activity in a case of acute organophosphate poisoning
title_full_unstemmed Continuous renal replacement therapy increased plasma cholinesterase activity in a case of acute organophosphate poisoning
title_short Continuous renal replacement therapy increased plasma cholinesterase activity in a case of acute organophosphate poisoning
title_sort continuous renal replacement therapy increased plasma cholinesterase activity in a case of acute organophosphate poisoning
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732211/
https://www.ncbi.nlm.nih.gov/pubmed/34510883
http://dx.doi.org/10.4266/acc.2021.00780
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