Abstract
A 22-year-old man attempted to commit suicide by swallowing an unknown amount of barium carbonate dissolved in hydrochloric acid. Shortly after ingestion, he developed crampy abdominal pain and generalized muscle weakness. About 2 h later, respiratory failure ensued necessitating orotracheal intubation and mechanical ventilation. Concomitantly, life-threatening arrhythmias including ventricular fibrillation occurred, and he had to be resuscitated for 45 min. After correction of severe hypokalemia (serum potassium 1.5 mmol/1), cardiac rhythm stabilized. In an attempt to accelerate removal of barium from the circulation hemodialysis was begun. During hemodialysis muscle strength returned. Pharmacokinetic analysis of serum barium levels suggest that hemodialysis shortened the serum half-life of barium. Subsequently, the patient made a complete and uneventful recovery. Our case demonstrates that severe barium poisoning can be survived provided that early aggressive therapeutic measures are undertaken. Hemodialysis seems to be efficacious in the therapy of barium intoxication.
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References
Greenfield S (1980) Plasma spectroscopy comes of age. Pure Appl Chem 52:2509–2523
Gossein RE, Smith RP, Hodge HC, Braddock JE (1984) clinical toxicology of commercial products, 5th edn. Williams and Wilkins, Baltimore, pp III—61—63
Daunderer M (1987) Barium. Klinische Toxikologie-27. Erg.-Lfg. 7/87
Sjodin RA, Ortiz O (1975) Resolution of the potassium ion pump in muscle fibers using barium ions. J Gen Physiol 66:269–286
Layzer RB (1982) Periodic paralysis and the sodium-potassium pump. Ann Neurol 11:547–552
Phelan DM, Hagley SR, Guerin MD (1984) Is hypokalaemia the cause of paralysis in barium poisoning. Br Med J 289:882
Roza O, Berman L (1971) The pathophysiology of barium: hypokalemic and cardiovascular effects. J Pharmacol Exp Ther 177:433–439
Berggren PO, Andersson B, Hellman B (1982) Stimulation of the insulin secretory mechanism following barium accumulation in pancreatic β-cells. Biochim Biophys Acta 720:320–328
Wetherill SF, Guarino MJ, Cox RW (1981) Acute renal failure associated with barium chloride poisoning. Ann Intern Med 95:187–188
Berning J (1975) Hypokalaemia of barium poisoning. Lancet I:110
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Schorn, T.F., Olbricht, C., Schüler, A. et al. Barium carbonate intoxication. Intensive Care Med 17, 60–62 (1991). https://doi.org/10.1007/BF01708412
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DOI: https://doi.org/10.1007/BF01708412