'Ecstasy' intoxication: life-threatening manifestations and resuscitative measures in the intensive care setting
'Ecstasy' intoxication: life-threatening manifestations and resuscitative measures in the intensive care setting
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DOI：
10.1097/00063110-200312000-00013
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发表时间：
2003-12-01
影响因子：
4.4
通讯作者：
Weinbroum, Avi A.
中科院分区：
文献类型：
--
作者：
Ben-Abraham, Ron;Szold, Oded;Weinbroum, Avi A.
目的：摄入 3,4-亚甲二氧基甲基苯丙胺（“摇头丸”）可导致严重的神经功能障碍和多系统损伤。我们描述了从紧急服务中心转移到重症监护区的患者可能危及生命的临床特征以及这种迷幻药物中毒的处理。方法：我们对三个月内入住市立医院的“摇头丸”中毒患者进行了回顾性分析。结果：在被送往紧急服务中心的 32 名患者中，有 3 名（9.3%；平均年龄 21 +/- 2 岁）被转移 服用一到三片 150 毫克 3,4-亚甲二氧基甲基苯丙胺后，处于与癫痫发作相关的昏迷状态，被送往重症监护室。所有患者都需要人工通气，并且没有一个对疼痛刺激有反应。脑部计算机断层扫描和腰椎穿刺结果正常。主要临床表现为低钠血症、高热、横纹肌溶解、脱水和代谢性酸中毒，并伴有肝肾功能损害。所有三名患者均在 2.1 +/- 0.8 天的系统性支持护理后恢复意识，并在 4.3 +/- 2.1 天后出院，在内科病房接受进一步监测。结论：危及生命的 3,4-亚甲二氧基甲基苯丙胺中毒事件增加，需要在重症监护环境中入院、治疗和密切监测，因此有必要制定适当的管理方案 最大限度地减少直接死亡率和晚期发病率。 (c) 2003 年利平科特·威廉姆斯和威尔金斯。
Objective: The ingestion of 3,4-methylenedioxymethamphetamine ('ecstasy') can cause severe neurological impairment and multi-system damage. We describe the potentially life-threatening clinical features and the management of intoxication by this psychedelic drug in patients transferred from emergency services to the intensive care area.Methods: We conducted a retrospective analysis of 'ecstasy'-intoxicated patients admitted to a municipal hospital during a three-month period.Results: Of the 32 patients brought to the emergency services, three (9.3%; mean age 21 +/- 2 years) were transferred to the intensive care area in a comatose state associated with seizures after ingesting one to three tablets of 150 mg 3,4-methylenedioxymethamphetamine. All required artificial ventilation and none responded to painful stimuli. The brain computed tomography scan and lumbar puncture results were normal. The main clinical manifestations were hyponatremia, high fever, rhabdomyolysis, dehydration and metabolic acidosis accompanied by impaired liver and renal functions. All three patients regained consciousness after 2.1 +/- 0.8 days of system-oriented supportive care and were discharged for further surveillance in medical wards after 4.3 +/- 2.1 days.Conclusion: The increase in life-threatening episodes of 3,4-methylenedioxymethamphetamine intoxication that mandate admission, treatment and close surveillance in an intensive care milieu make it incumbent to establish appropriate management protocols for minimizing immediate mortality and late morbidity. (c) 2003 Lippincott Williams & Wilkins.