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KMID : 0604020110260030177
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Korean Journal of Critical Care Medicine
2011 Volume.26 No. 3 p.177 ~ p.180
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A Case of Acute on Chronic Salicylate Poisoned Elderly Patient with Early Utilization of Continuous Venovenous Hemodiafiltration
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Lee Ji-Sook
Jeon Woo-Chan
Min Young-Gi
Ryu Won-Hyun
Jung Yoon-Seok
Choi Sang-Chun
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Abstract
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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.
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KEYWORD
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continuous venovenous hemodiafiltration (CVVHDF), elderly, poisoning, salicylate
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