Usefulness of forced diuresis for acute boric acid poisoning in an adult
Usefulness of forced diuresis for acute boric acid poisoning in an adult
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DOI：
10.1046/j.1365-2710.2001.00365.x
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发表时间：
2001-10-01
影响因子：
2
通讯作者：
Oishi, R
中科院分区：
文献类型：
--
作者：
Teshima, D;Taniyama, T;Oishi, R
背景：硼酸一般不被认为是有毒物质。然而，硼酸具有潜在的致命作用，如低血压、代谢性酸中毒和少尿。死亡可能是由于循环衰竭和休克。目的：我们介绍了成功地使用速尿和静脉输液强制利尿抢救硼酸中毒的临床病例。方法：在重症监护室连续4h给予L静脉输液3.25g，速尿100m g，连续4h测定血、尿中的硼酸浓度。结果：利尿法所得的硼酸清除率与同一次血液透析未遂的硼酸清除率相近。患者仅出现一过性呕吐和腹泻，并伴有红斑，入院4h后被转移到普通病房。在普通病房，患者发热持续，恶心、呕吐、头痛反复出现，可能与速尿用量不足有关，但在入院后h内病情逐渐好转。结论：硼酸中毒患者入院后应早期强制利尿而不进行血液透析。
Background: Boric acid is generally not recognized as a poisonous substance. However, boric acid has potentially fatal actions such as hypotension, metabolic acidosis and oliguria. Death may result from circulation collapse and shock.Objective: We present a clinical case history of the successful use of forced diuresis with furosemide and intravenous fluid for boric acid poisoning.Subject: A 26-year-old female who attempted suicide by consuming a large quantity of boric acid. She was brought to the hospital in a state of clouded consciousness, fever and erythema 14 h after ingestion.Method: 3.25 L of intravenous fluid and 100 mg of furosemide were administered over a period of 4 h in the intensive care unit and the serum and urinary concentrations of boric acid measured.Results:The elimination rate of boric acid obtained with diuresis was similar to that obtained with haemodialysis on a previous occasion when the same patient attempted suicide with boric acid. The patient showed only temporary emesis and diarrhoea along with erythema, and was moved to the general ward 4 h after admission. Although in the general ward the patient's fever persisted and nausea, vomiting and headache often recurred, possibly because of an insufficient dose of furosemide, the patient's condition steadily improved over the 64 h after admission.Conclusion: Forced diuresis without haemodialysis is recommended early after admission for boric acid poisoning.