Issue: Vojnosanit Pregl 2016; Vol. 73 (No. 4)
Intravenous lipid emulsion in treatment of cardiocirculatory disturbances caused by glyphosate-surfactant herbicide poisoning
Authors:
Jasmina Jović-Stošić, Vesna Putić, Nataša Perković-Vukčević, Gordana Babić, Snežana Djordjević, Zoran Šegrt
Introduction. Glyphosate is the first widely used herbicide againstweed in genetically modified crops. Though glyphosate itself has a
low toxicity, commercial products are more dangerous because of
increased toxicity due to surfactants addition. There is no specific
antidote for the poisoning with glyphosate-surfactant (Gly-SH). In
recent times, the efficacy of intravenous lipid emulsion (ILE) administration
for the treatment of acute poisoning caused by Gly-
SH has been investigated. Case Report. A 50-year-old man was
admitted 3 h after self-poisoning with herbicide containing glyphosate
and polyoxyethyleneamine, as a surfactant. On admission,
the patient was in a coma, hypotensive (80/50 mmHg) and without
spontaneous breathing. Electrocardiogram showed widecomplex
tachycardia, and arterial blood gas (ABG) revealed acidosis
(pH 7.07). Conventional treatment included mechanical ventilation,
intravenous fluids, bicarbonate and dopamine. As there was
no improvement, ILE was started. The patient received 100 mL of
20% Intralipid® bolus followed by infusion of 400 mL over 20
minutes. Prior to expiration of infusion, a gradual rise in blood
pressure was noted, and within 2 hours sinus rhythm was restored.
Conclusion. This case report suggests that the use of ILE may be
an additional option for the treatment of cardiocirculatory disturbances
caused by commercial products of glyphosate herbicide.
