24 years, the married female took 4 tablets of celphas. She went to primary physicians after 2 hours, he did gastric lavage, gave 100ML coconut oil through RT, and send the patient to me as she was hypotensive. The patient came with, hr-130, BP100/50 ON DOPA AND NORADR, RR 24, SPO2 95% ON RA, Her ABG- ph-7.30, PCO2-24,HCO3-12. It is total 5 hours since she took celphas.
This is our 15th case who survived after taking such a high dose and despite hypotension. Only key to survival was referral in time and aggressive CRRT. Only treatment which makes difference in outcome is high volume continues renal replacement therapy at a dose of 35 to 40 ml / kg / hour along with other supportive treatment like adrenaline, noradrenaline, and mgso4. CRRT helps in correcting acidosis, maintaining homeostasis and avoid fluid overload. Most of the time patient needs 36 to 48 hrs of CRRT, and after that most of the patients recover.
What I have found with time that starting CRRT within 2 hours of taking the drug saves most of the patients. That means early referral for doing high volume CRRT can salvage most of the patient.
