Intoxication by large amounts of barium nitrate overcome by early massive K supplementation and oral administration of magnesium sulphate

Payen, Christine; Dellinger, A.; Pulce, C.; Cirimele, Vincent; Carbonnel, Vincent; Kintz, Pascal; Descotes, Jacques

doi:10.1177/0960327110366781

Cited by 12 publications

(4 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Activated charcoal is ineffective. The use of oral sulfate salts such as sodium or magnesium sulfate may be considered early to decrease absorption by converting the barium into the nontoxic barium sulfate in the gastrointestinal tract [10]. Intravenous sulfates should be avoided to prevent the theoretical risk of intravascular precipitation and subsequent acute kidney injury.…”

Section: Discussionmentioning

confidence: 99%

Barium poisoning: an uncommon cause of severe hypokalemia

McNeill

Isoardi

2019

Toxicology Communications

View full text Add to dashboard Cite

Barium poisoning is uncommon. Barium salts are used in a number of industries, including mining, ceramics, plastics, and adhesives and as a green coloring in fireworks. It is also a rodenticide. In poisoning, it blocks passive efflux potassium channels without affecting the Na/K-ATPase pump resulting in an increase in intracellular potassium and extracellular hypokalemia. A 44-year-old man self-presented to hospital six hours following deliberately ingesting 10 g of barium carbonate with suicidal intention. On presentation, he had profuse vomiting with decreased power globally and hyporeflexia in his upper and lower limbs. His ECG was in sinus rhythm with first-degree heart block and diffuse T wave flattening and U wave formation. He had severe hypokalemia with a potassium concentration of 2.4 mmol/L. He was managed supportively with antiemetics and supplemental potassium, receiving 80 mmol of intravenous potassium chloride in total. He was discharged home 24 hours post-ingestion. Soluble barium salts are highly toxic and clinical effects include hypokalemia, flaccid paralysis, cardiac arrest and death. Management of barium toxicity is largely supportive, focusing on the correction of hypokalemia. Oral sulfate salts may prevent absorption through precipitating insoluble barium sulfate in the gastrointestinal tract. Hemodialysis increases elimination and can be considered in severe poisoning.

show abstract

Section: Discussionmentioning

confidence: 99%

Barium poisoning: an uncommon cause of severe hypokalemia

McNeill

Isoardi

2019

Toxicology Communications

View full text Add to dashboard Cite

show abstract

“…Characteristic clinicopathological features of barium poisoning are the acute onset and quick progression of flaccid paralysis coexisting with severe hypokalemia . Treatment consists of supportive therapy, aggressive potassium supplementation, and chelation therapy . To the authors’ knowledge, this represents the first report of firework ingestion as the source of confirmed barium intoxication in the veterinary literature.…”

Section: Introductionmentioning

confidence: 99%

Acute barium poisoning in a dog after ingestion of handheld fireworks (party sparklers)

Stanley

Kelers

Boller

et al. 2019

J Vet Emergen Crit Care

View full text Add to dashboard Cite

Objective:To report a case of acute barium poisoning in a dog subsequent to ingestion of a common handheld pyrotechnic (sparkler). Case summary: A 5-year-old female neutered German Shorthaired Pointer presented with acute onset of generalized flaccid muscle paralysis and fasciculations, ptyalism, and an irregular heart rhythm. Marked hypokalemia (1.9 mmol/L [mEq/L]; reference range [3.5-5.8 mmol/L [mEq/L]), acidemia (pH 7.20; reference range 7.38-7.44), and hypoventilation (PvCO 2 55 mm Hg; reference range 40-50 mm Hg) were present on admission. Treatment consisted of fluid therapy, aggressive IV potassium chloride supplementation, gastric lavage, and oral magnesium sulfate administration. Based on history and clinical presentation, barium intoxication after ingestion of handheld firework (sparklers) was suspected and a serum sample was submitted for barium analysis. The serum barium concentration determined by inductively coupled plasma/mass spectrometry was 2,000 g/L, a 3 orders of magnitude elevation above previously reported normal values in dogs. Within 18 hours of admission, the clinical signs resolved and the blood potassium concentration normalized. The animal was discharged home 36 hours after admission. On follow-up performed after 1 and 5 years, no health issues were apparent. New information provided: To the authors' knowledge, this is the first report of acute, lifethreatening barium toxicosis characterized by flaccid paralysis, acidemia, and severe hypokalemia occurring in a dog after ingestion of a popular pyrotechnic (sparkler) containing barium nitrate. Clinical signs may resolve within 24 hours with appropriate supportive care including aggressive potassium supplementation and chelation therapy. K E Y W O R D S barium, fireworks, hypokalemia, intoxication, muscular weakness J Vet Emerg Crit Care. 2019;29:201-207. wileyonlinelibrary.com/journal/vec 201

show abstract

“…1 Prior case reports in medical literature describe the clinical course after accidental exposure to barium chloride, barium nitrate, and barium acetate. [2][3][4] Rare cases of deaths attributed to exposure to barium chloride, usually from unintentional exposure, have been reported. 5 Deaths from intentional barium ingestion are rare, with only 3 cases reported in literature, 6 although there are also reports of patients who have voluntarily ingested barium compounds and survived.…”

mentioning

confidence: 99%

“…Barium compounds have numerous industrial uses including in mining and in the manufacture of paint, glass, bricks, and insect and rat poisons 1 . Prior case reports in medical literature describe the clinical course after accidental exposure to barium chloride, barium nitrate, and barium acetate 2–4 . Rare cases of deaths attributed to exposure to barium chloride, usually from unintentional exposure, have been reported 5 .…”

mentioning

confidence: 99%

Suicide by an Unusual Compound

Fenu

Brower

O’Neill

2021

Am J Forensic Med Pathol

View full text Add to dashboard Cite

Forensic pathologists may sometimes encounter cases of suicide with ingestion of unusual compounds. Herein, we describe a case of suicide by ingestion of barium acetate. Deaths by ingestion of this compound have not previously been reported in literature. This case shows the clinical presentation of the toxicity of barium compounds and highlights the importance of scene investigation and clinicopathologic correlation in suicides by unusual ingestion.

show abstract

Intoxication by large amounts of barium nitrate overcome by early massive K supplementation and oral administration of magnesium sulphate

Cited by 12 publications

References 19 publications

Barium poisoning: an uncommon cause of severe hypokalemia

Barium poisoning: an uncommon cause of severe hypokalemia

Acute barium poisoning in a dog after ingestion of handheld fireworks (party sparklers)

Suicide by an Unusual Compound

Contact Info

Product

Resources

About