Characteristics of lactic acidosis in patients with acute poisoning due to drugs and chemicals

 https://doi.org/10.52322/jocmbmh.08.en.04

ABSTRACT

Objectives: to describe the characteristics of lactic acidosis in patients with acute poisoning due to drugs and chemicals.

Material and Methods: A case-series 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: methanol poisoning with lactate at admission was higher than ethanol (9.4 and 4.7 mmol/l; p<0.01); lactate returned to normal more slowly (27.8 and 8.2 hours; p<0.01); later hospitalization, severe complications and multi-organ failure were higher than ethanol (p<0.01); died from methanol poisoning only (40%), lactate at admission ≥10 mmol/l has 66.7% died. 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 increases; no serious complications and death. Biguanide 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 of complications.

Keywords: Lactic acidosis, acute poisoning

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