A Successful Treatment of Patient with Fatal Complications after beta-fluoroethyl acetate Ingestion

ABSTRACT

The highly toxic sodium monofluoroacetate (SMFA) was banned as a rodenticide in this country in the 1980s. The fluoroacetate metabolite, fluorocitric acid blocks cellular metabolism by inhibiting the Klebs cycle, producing wide spread clinical effects including respiratory, neurologic, cardiologic, and fluid-electrolyte abnormalities. We report the survival case by continuous renal replacement therapy from fatal complications after beta-fluoroethyl acetate ingestion. 61-year old male was brought to our emergency center with chief complaint of beta-fluoroethyl acetate ingestion. Soon after 80 minutes of hospital admission, he developed the symptoms of mild metabolic acidosis, respiratory failure, coma, transient tachycardia, and refractory hypotension. On the second hospital day, we guessed that drug induced severe rhabdomyolysis and renal failure were in progress. At 28 hours after hospital admission, we started the continuous renal replacement therapy (CRRT) with the informed consent. Dramatically, at 24 hour after beginning the CRRT, the patient were completely recovered from coma, respiratory failure, and refractory shock, although severe rhabdomyolysis and renal failure still existed. Additionally, four times of hemodialysis were performed. On 25th hospital admission, he discharged with non oliguric renal failure state, arranging to return to out patient department.