Scholarlink

Background <p>Phosphine, a highly potent insecticide, can cause damage to multiple physiological systems when inhaled by humans, including the nervous, circulatory, and urinary systems. Currently, there is no effective antidote for phosphine poisoning, which highlights the importance of systematic and effective supportive treatment.</p> Case presentation <p>This paper presents a case of a patient with Down syndrome who had a history of similar gas poisoning and was exposed to high-concentration phosphine gas within 10&#xa0;min, resulting in inhalation poisoning and shock. Upon admission to our hospital, the patient’s left ventricular ejection fraction (LVEF) dropped to 34% (55%-75%), lactate dehydrogenase (LDH): 586 U/L (120–250 U/L), and creatine kinase-MB (CK-MB): 12.75 ng/ml (0–5 ng/ml), indicating severe cardiac function impairment. Treatment included mechanical ventilation and PICCO-guided hemodynamic management. During treatment, the patient’s whole-blood lactate concentration peaked at 12.5 mmol/L (nearly eight times the normal range), for which continuous renal replacement therapy (CRRT) was administered. Additionally, the comprehensive application of continuous norepinephrine infusion for circulatory maintenance, targeted correction of acidosis, and administration of metaraminol and dobutamine for inotropic support were crucial for improving the patient’s prognosis. Ultimately, the patient was successfully cured.</p> Conclusions <p>In this case, disproportionate myocardial injury relative to pulmonary injury was observed, which may be caused by acute exposure to high concentrations of phosphine. Furthermore, the patient’s history of similar gas poisoning and Down syndrome may also contribute to this manifestation. Given the lack of a specific antidote for phosphine poisoning, our supportive treatment emphasizes the importance of PICCO for shock management and early CRRT intervention for lactate elimination and internal environment stabilization. This report provides practical experience for the treatment of phosphine poisoning, particularly for associated cardiac function damage.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Case report: acute phosphine inhalation poisoning in a patient with Down's syndrome

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月12日

查看全文
  • Xingchi Yu,
  • Jianlong Zhang,
  • Jiangjian Xu,
  • Keqi Dong,
  • Lu Jin,
  • XueBin Wen,
  • Xiaojing Zhou

摘要

Background

Phosphine, a highly potent insecticide, can cause damage to multiple physiological systems when inhaled by humans, including the nervous, circulatory, and urinary systems. Currently, there is no effective antidote for phosphine poisoning, which highlights the importance of systematic and effective supportive treatment.

Case presentation

This paper presents a case of a patient with Down syndrome who had a history of similar gas poisoning and was exposed to high-concentration phosphine gas within 10 min, resulting in inhalation poisoning and shock. Upon admission to our hospital, the patient’s left ventricular ejection fraction (LVEF) dropped to 34% (55%-75%), lactate dehydrogenase (LDH): 586 U/L (120–250 U/L), and creatine kinase-MB (CK-MB): 12.75 ng/ml (0–5 ng/ml), indicating severe cardiac function impairment. Treatment included mechanical ventilation and PICCO-guided hemodynamic management. During treatment, the patient’s whole-blood lactate concentration peaked at 12.5 mmol/L (nearly eight times the normal range), for which continuous renal replacement therapy (CRRT) was administered. Additionally, the comprehensive application of continuous norepinephrine infusion for circulatory maintenance, targeted correction of acidosis, and administration of metaraminol and dobutamine for inotropic support were crucial for improving the patient’s prognosis. Ultimately, the patient was successfully cured.

Conclusions

In this case, disproportionate myocardial injury relative to pulmonary injury was observed, which may be caused by acute exposure to high concentrations of phosphine. Furthermore, the patient’s history of similar gas poisoning and Down syndrome may also contribute to this manifestation. Given the lack of a specific antidote for phosphine poisoning, our supportive treatment emphasizes the importance of PICCO for shock management and early CRRT intervention for lactate elimination and internal environment stabilization. This report provides practical experience for the treatment of phosphine poisoning, particularly for associated cardiac function damage.