Indian Journal of Critical Care Case Report

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VOLUME 3 , ISSUE 5 ( September-October, 2024 ) > List of Articles

CASE REPORT

Emerging Indications for Extracorporeal Interventions: Hemoperfusion for Glufosinate Ammonium Poisoning

Venkatesh Narendiran, Sasi Mayukha Challa Venkat, Balaji Venkatachalam, Radha Venkatramanan, G Rangaprasad

Keywords : Case report, Extracorporeal interventions, Glufosinate ammonium, Hemoperfusion

Citation Information : Narendiran V, Venkat SM, Venkatachalam B, Venkatramanan R, Rangaprasad G. Emerging Indications for Extracorporeal Interventions: Hemoperfusion for Glufosinate Ammonium Poisoning. 2024; 3 (5):145-146.

DOI: 10.5005/jp-journals-11006-0136

License: CC BY-NC 4.0

Published Online: 27-08-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim and background: Glufosinate-ammonium (GLA), a herbicide commonly used in Andhra Pradesh, becomes toxic upon accidental consumption in undiluted form, affecting multiple organ systems. There is no specific antidote, only symptomatic treatment available for this type of poisoning. Conventional treatment methods may not always yield satisfactory outcomes due to varied toxicokinetics. This case report highlights the significance of promptly initiating resin hemoperfusion to effectively clear the lipophilic glufosinate compounds in an intensive care setting. Case description: A 50-year-old male presented to our hospital after ingesting approximately 250 mL of 13.5% GLA compound. He exhibited altered sensorium and seizures, which were attributed to hyperammonemia. After stabilizing airway, breathing, and circulation (ABC), he underwent two cycles of resin-based hemoperfusion lasting 3.6 hours each, resulting in a gradual reduction in ammonium levels and an improvement in sensorium. Eventually, he was weaned off and extubated successfully from mechanical ventilation and discharged without any neurological deficits. Conclusion: This approach yielded several positive outcomes like reduction of hyperammonemia, improvement of neurological manifestations, shortened intensive care unit (ICU) stay, facilitated early weaning from mechanical ventilation. Clinical significance: The early recognition of neurological symptoms and the timely implementation of hemoperfusion, were instrumental in achieving positive outcomes.


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