Successful extracorporeal membrane oxygenation support for severe acute diquat and glyphosate poisoning

Abstract

Rationale: Because of the lack of an antidote or effective treatment, patients with severe acute diquat and glyphosate poisoning always died within a few hours. Extracorporeal membrane pulmonary oxygenation (ECMO), as an artificial heart-lung supporting system, can be applied to support lung that is expected to recover from reversible pathological damage. However, to our knowledge, the application of ECMO for patients with diquat and glyphosate poisoning has not been reported. Patient concerns: A 40-year-old man ingested in 100 ml of diquat (20 g/100 ml) and 400 ml glyphosate (41 g/100 ml) was admitted to the intensive care unit (ICU), immediately complicated by the development of ventricular fibrillation, respiratory failure, renal failure, and multi-organ failure. Diagnosis: Diquat and glyphosate poisoning were diagnosed by stated ingestion history, and the diagnostic criteria for acute respiratory distress syndrome (ARDS) and multi-organ dysfunction syndrome were also met. Interventions: He was treated with veno-venous ECMO. Outcomes: He was successfully transferred out of the ICU on day 46 and discharged on day 67. The computed tomography scan showed no obvious pulmonary fibrosis 2 months after poisoning. Lessons: ECMO may be effective in the treatment of patients with severe ARDS caused by diquat and glyphosate poisoning when conventional management does not work.

Concentration Distribution and Analysis of Urinary Glyphosate and Its Metabolites in Occupationally Exposed Workers in Eastern China

“…Although more and more cases of health damage from GLY and preparations have been reported in recent years [10,11], there are still many different opinions on its toxicity [12]. The main divergences focus on two aspects.…”

High-dose diquat poisoning: a case report

“…With respect to respiratory failure caused by diquat poisoning, one patient was successfully saved by venovenous extracorporeal membrane oxygenation (ECMO) 11 in a previous report. That patient had ingested about 100 mL of diquat (20 g per 100 mL) and 400 mL of glyphosate (41 g per 100 mL); this dose was much lower than that in our patient, and the previous patient vomited the herbicides soon after ingestion.…”

Successful Treatment of Severe Myocardial Injury Complicated With Refractory Cardiogenic Shock Caused by AOPP Using Extracorporeal Membrane Oxygenation

“…As a bridge to recovery from cardiopulmonary failure, ECMO can improve the survival rate of patients with refractory cardiogenic shock following poisoning [12][13][14] . Vardon [15] et al reported the successful rescue of patients with intractable ventricular arrhythmia and cardiogenic shock caused by severe yew poisoning using VA-ECMO.…”