South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde · 1996
Intensive therapy for chloroquine poisoning. A review of 29 cases.
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McKenzie A G
Аннотация
OBJECTIVE: To obtain a data base of the features of chloroquine poisoning and to assess existing intensive therapy for it.
DESIGN: Retrospective review of all confirmed cases of acute chloroquine poisoning admitted to intensive care between November 1990 and October 1994. All available records were scrutinised.
SETTING: The intensive care units of Harare Central and Parirenyatwa hospitals, which are referral centres in Harare.
PATIENTS: Selection of patients depended on positive confirmation of chloroquine ingestion. Cases of concomitant ingestion of other drug(s) were not excluded.
MAIN OUTCOME MEASURES: Cardiac arrest or not; death or survival to discharge from hospital.
MAIN RESULTS: Of a total of 29 patients, aged 16-51 years, 69% (20) were female and 31% (9) male. The commonest clinical features were respiratory failure, depressed level of consciousness, hypothermia, hypotension, cardiac arrest and hypokalaemia. Eleven patients had at least one cardiac arrest; 5 of these were successfully resuscitated. Management included gastric lavage, intravenous diazepam, mechanical ventilation when necessary, and occasionally inotropic infusions. Four patients suffered cardiac arrest during gastric lavage. There were 6 deaths (mortality 20.7%).
CONCLUSIONS: This study indicates the common clinical features of acute chloroquine poisoning. A survival rate of about 80% is being achieved by intensive therapy at Harare Central and Parirenyatwa Hospitals. Rapid utilisation of the treatment regimen described should reduce the mortality to less than 10%.
DESIGN: Retrospective review of all confirmed cases of acute chloroquine poisoning admitted to intensive care between November 1990 and October 1994. All available records were scrutinised.
SETTING: The intensive care units of Harare Central and Parirenyatwa hospitals, which are referral centres in Harare.
PATIENTS: Selection of patients depended on positive confirmation of chloroquine ingestion. Cases of concomitant ingestion of other drug(s) were not excluded.
MAIN OUTCOME MEASURES: Cardiac arrest or not; death or survival to discharge from hospital.
MAIN RESULTS: Of a total of 29 patients, aged 16-51 years, 69% (20) were female and 31% (9) male. The commonest clinical features were respiratory failure, depressed level of consciousness, hypothermia, hypotension, cardiac arrest and hypokalaemia. Eleven patients had at least one cardiac arrest; 5 of these were successfully resuscitated. Management included gastric lavage, intravenous diazepam, mechanical ventilation when necessary, and occasionally inotropic infusions. Four patients suffered cardiac arrest during gastric lavage. There were 6 deaths (mortality 20.7%).
CONCLUSIONS: This study indicates the common clinical features of acute chloroquine poisoning. A survival rate of about 80% is being achieved by intensive therapy at Harare Central and Parirenyatwa Hospitals. Rapid utilisation of the treatment regimen described should reduce the mortality to less than 10%.