Treatment of patients with acute arsine poisoning / 中华急诊医学杂志

ABSTRACT

Objective To study the characteristics of patients with acute arsine poisoning and its possible treatments. Methods The only use of drugs,or drugs with plasma exchange(PE)were used to treat 36 patients with acute arsine poisoning.The blood haemolysis,enzymes of creatinc kinase(CK),lactate dehydrogenase(LDH),alkaline phosphatase (ALP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),?-hydroxybutyric dehydrogenase(HHBD), total bihrubin(TBIL),indirect bilirubin(IBIL),direct bilirubin(DBIL),blood urea nitrogen(BUN),serum creatinine (Cr)were observed.Results There was an exposure time-effect relation in clinical characteristics,and a linear correlation between the concentrations of arsenic in blood and urine(r=0.718,P=0.019),but no significant correlations were found between the concentrations of arsenic in blood or urine with CK,LDH,ALP,ALT,AST,HHBD,TBIL,IBIL, DBIL,BUN,Cr(P＞0.05).In patients with severe acute arsine poisoning,PE quickly controlled hemolysis within 24 hours,and prevented secondary damage in kidney and other organs,oliguria stage got much shorter,and CK,LDH,ALP, AST,HHBD,TBIL,IBIL,BUN significantly reduced at 24 to 72 hours after PE treatment(P＜0.05).Conclusions The only use of drug was enough for the treatment of mild acute arsine poisoning.To the patients with severe acute arsine poisoning,PE may be an effective method to control its blood hemolysis and prevent complications,which should be taken as early as possible.