Brief Report: A Case of Tramadol Overdose: Extracorporeal Life Support and Hemoperfusion as Life-Saving Treatment.


Journal

Blood purification
ISSN: 1421-9735
Titre abrégé: Blood Purif
Pays: Switzerland
ID NLM: 8402040

Informations de publication

Date de publication:
2020
Historique:
received: 28 11 2019
accepted: 09 01 2020
pubmed: 6 2 2020
medline: 4 5 2021
entrez: 5 2 2020
Statut: ppublish

Résumé

We describe the case of a 49-year-old woman with a Tramadol intoxication associated with multiorgan failure. Veno-arterial femoro-femoral extracorporeal life support (VA-ECLS) and hemoperfusion (HP) were used as rescue treatments. The emergency medical service found a woman at home unconscious. Once in the hospital, she was intubated and catecholamines support was immediately started for a severe shock. Brain CT was normal, whereas EEG revealed a metabolic encephalopathy pattern. Toxic levels of Tramadol and Quetiapine were detected. VA-ECLS was implanted due to persistent multiorgan failure, and HP with a charcoal cartridge was set to increase the Tramadol clearance. To quantify the charcoal cartridge's removal efficiency of Tramadol, Tramadol concentration was measured before and after the cartridge and before and after the treatment in the patient's blood. The charcoal cartridge showed good extraction ratio during the treatment and no significant rebound effect. VA-ECLS and HP allowed the patient to be weaned from vasoconstrictors and the resolution of the organ failures. These treatments might be lifesaving in the Tramadol intoxication.

Identifiants

pubmed: 32018266
pii: 000505845
doi: 10.1159/000505845
doi:

Substances chimiques

Analgesics, Opioid 0
Tramadol 39J1LGJ30J

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

509-512

Informations de copyright

© 2020 S. Karger AG, Basel.

Auteurs

Fiorenza Ferrari (F)

Department of Anaesthesia and Intensive Care Unit, I.R.C.C.S. San Matteo Hospital and University of Pavia, Pavia, Italy, fioreferrari28@gmail.com.
International Renal Research Institute of Vicenza (IRRIV), San Bortolo Hospital, Vicenza, Italy, fioreferrari28@gmail.com.

Alessandro Carletti (A)

Department of Anaesthesia and Intensive Care Unit, I.R.C.C.S. San Matteo Hospital and University of Pavia, Pavia, Italy.

Nicola Peroni (N)

Department of Anaesthesia and Intensive Care Unit, I.R.C.C.S. San Matteo Hospital and University of Pavia, Pavia, Italy.

Silvia Mongodi (S)

Department of Anaesthesia and Intensive Care Unit, I.R.C.C.S. San Matteo Hospital and University of Pavia, Pavia, Italy.

Pasquale Esposito (P)

Unit of Nephrology Dialysis and Transplantation, IRCCS Policlinico San Matteo, Pavia, Italy.
Department of Internal Medicine, Nephrology, Dialysis and Transplantation Clinics, Genoa University and IRCCS Ospedale Policlinico San Martino, Genova, Italy.

Anita Orlando (A)

Department of Anaesthesia and Intensive Care Unit, I.R.C.C.S. San Matteo Hospital and University of Pavia, Pavia, Italy.

Francesco Mojoli (F)

Department of Anaesthesia and Intensive Care Unit, I.R.C.C.S. San Matteo Hospital and University of Pavia, Pavia, Italy.
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Unit of Anesthesia and Intensive Care, University of Pavia, Pavia, Italy.

Claudio Ronco (C)

International Renal Research Institute of Vicenza (IRRIV), San Bortolo Hospital, Vicenza, Italy.
Department of Nephrology, University of Padova, Padova, Italy.
Department of Nephrology Dialysis and Transplant-AUSSL 8 regione Veneto -San Bortolo Hospital, Vicenza, Italy.

Mirko Belliato (M)

Department of Anaesthesia and Intensive Care Unit, I.R.C.C.S. San Matteo Hospital and University of Pavia, Pavia, Italy.

Giorgio A Iotti (GA)

Department of Anaesthesia and Intensive Care Unit, I.R.C.C.S. San Matteo Hospital and University of Pavia, Pavia, Italy.

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