A case of pilsicainide poisoning in which continuous hemodiafiltration (CHDF) was effective : A case report and review of the literatures

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  • Masumitsu Akane
    National Hospital Organization Kyoto Medical Center, Critical Care Center, Emergency Medicine Shiga University of Medical Science, Legal Medicine
  • Kawasaki Sadao
    National Hospital Organization Minami Wakayama Medical Center, Critical Care Center, Emergency Medicine
  • Hitosugi Masahito
    Shiga University of Medical Science, Legal Medicine

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  • 持続濾過透析（continuous hemodiafiltration；CHDF）が有効であったピルジカイニド中毒の1例―自験例および本邦報告例の検討―
  • ジゾク ロカ トウセキ(continuous hemodiafiltration ; CHDF)ガ ユウコウ デ アッタ ピルジカイニド チュウドク ノ 1レイ : ジケンレイ オヨビ ホンポウ ホウコクレイ ノ ケントウ

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Abstract

<p>We report a man in his forties with pilsicainide poisoning in whom circulatory dynamics improved promptly by hemocatharsis. After taking 20 capsules of pilsicainide orally, he was taken to our hospital. On arrival, he was in a state of shock, and the electrocardiogram showed bradycardia and wide QRS. After undergoing continuous hemodiafiltration, the QRS width narrowed, the patient's heart rate increased, and the circulatory dynamics improved promptly. Because pilsicainide is excreted by kidneys, it remains in the body longer when renal function is impaired. Although no specific treatments have been established for pilsicainide poisoning, hemocatharsis has often been performed. After reviewing the reports of pilsicainide poisoning in our country, we compared cases in which hemocatharsis was and was not performed. Hemocatharsis was performed for patients with more unstable circulatory dynamics and higher serum creatinine concentrations compared with patients without hemocatharsis. Although pilsicainide is not removed from the body by hemocatharsis, circulatory dynamics are improved promptly using this approach. Therefore, hemocatharsis would be effective for pilsicainide poisoning in patients with impaired renal function or those in a state of shock.</p>

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