TOAN LACTIC Ở BỆNH NHÂN NGỘ ĐỘC MỘT SỐ THUỐC VÀ HÓA CHẤT

Abstract

Objective: to describe the characteristics of lactic acidosis in patients with acute poisoning due to drugs and chemicals. Subjects and methods: a prospective descriptive study on 127 acute poisoning patients with lactic acidosis treated at the Poison Control Center of Bach Mai hospital from July 2019 to July 2020. Results: Alcohol poisoning: the lactate levels of methanol poisonings on admission were higher than those of ethanol poisonings (9.4 vs 4.7 mmol/l; p<0.01); lactate returned to normal more slowly (27.8 vs 8.2 hours; p<0.01); Patients with methanol intoxication were admitted to hospital later, had higher rates of severe complications and multi-organ failure than ethanol poisoned patients (p<0.01); the patients were only died from methanol poisoning (40%), lactate on admission ≥10 mmol/L had mortality rate of 66.7%. Paracetamol poisoning: early admission after 3.7 hours with lactate averaging 4.7 mmol/L and normalized after 9.5 hours; mild and moderate lactate increased; no serious complications and death. Biguanid poisoning: late admission (52 hours), severe lactate increase (100%), normalized after 48 hours; 100% metabolic acidosis and severe complications; mortality is 33%. Cyanide poisoning: early admission after 1.6 hours, severe lactate increase (40%) normalized after 14.4 hours; multi-organ failure and death 20%. Conclusion: Assessment of increased lactic acidosis and poisoning level help prognosis and early management.