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논문분류	춘계학술대회 초록집
제목	A 72-year-old Woman with Metabolic Acidosis, Acute Kidney Injury, and STEMI Complications : A Rare Case of Liquid Rodenticide Intoxication
저자	Melinda Didi Yudhanti
출판정보	2024; 2024(1):
키워드
초록	A 72-year-old woman was brought to the emergency room with complaints of shortness of breath after accidentally ingesting liquid rodenticide containing bromadiolone 0.5% with unknown solvent, about 15–30 minutes prior to hospital admission. Prior history of stroke (+), without history of hypertension or diabetes. From physical examinations, kussmaul breathing, fast and irregular heart sounds, and cold extremities were found. Laboratory results showed leukocytosis, increased BUN, creatinine, and potassium. Blood gas analysis (BGA) indicated metabolic acidosis with a pH of 7.007. The ECG identified AF with RVR. In the ER, oxygenation, gastric lavage, activated charcoal administration, sodium bicarbonate drip, hyperkalemia correction, and vitamin K injection were also performed. The patient was then treated in the ICU and underwent free-heparin hemodialysis due to a stress ulcer finding. After hemodialysis, the patient’s condition showed improvement with a pH of 7.252. However, on the third day, the patient experienced VT with a pulse, so cardioversion was performed at 100 J. The follow-up ECG showed STEMI with increased Hs-troponin and D-dimer. Heparin therapy was then initiated. The next hemodialysis was postponed due to access difficulties. BUN, creatinine, and the BGA were checked daily and showed improvement without hemodialysis. The patient was discharged after 12 days of hospitalisation. Discussion: Rodenticides, often marketed as "rat poisons," are mixtures of chemicals designed to eliminate rodents. Meanwhile, our hospital does not have a testing laboratory for toxic substances. Bromadiolone works by preventing the body from recycling vitamin K, which is needed for blood clotting. Our case is rare in clinical settings because blood clots were found in rodenticide with bromadiolone intoxication. Medical history can be a determinant of prognosis and complications of the current illness. Further testing for diagnosis should be considered for better clinical outcomes.
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