Intravenous Fat Emulsion Therapy in a Patient with Refractory Hypotension Caused by Glufosinate-Surfactant Herbicide

ABSTRACT

Status epilepticus and hypotension are the main causes of death from glufosinate-surfactant herbicide (GluSH) poisoning. Affected patients do not respond to general treatment. We encountered a 57 year-old female patient admitted to the emergency department after GluSH poisoning. She did not show any abnormal signs except for a mild drowsy mental status at presentation. During conservative management and observation, convulsion and hypotension occurred. After mechanical ventilator care and anticonvulsant administration, the convulsion was controlled but the hypotension was refractory to fluid resuscitation and vasopressors. Twenty-two hours after hospital admission, intravenous fat emulsion (IFE) was attempted. After IFE, the mean arterial pressure increased to more than 65 mmHg, and the left ventricular ejection fraction improved from 30% to 50%, so the vasopressors could be tapered. The patient received additional treatment and was discharged without complications.