Abstract
A 26-year-old female walked into our emergency department complaining of persistent nausea and feeling unwell after ingesting about 100 mL laundry detergent in a suicide attempt. The laundry detergent contained 17% of anionic and non-ionic surfactants. She had airway and breathing problems on arrival. We intubated her and performed gastric lavage, before administering activated charcoal and a laxative. We continued the infusion, but her blood lactate level kept rising, and progressive circulatory failure was observed. She fell into a state of shock, and we needed to use noradrenaline. We decided to perform direct hemoperfusion (DHP) using an activated charcoal column. After the initiation of the DHP, the patient’s blood lactate level fell immediately, and we were able to end the noradrenaline treatment. She was extubated on the 3rd hospital day and transferred to another hospital for specialized psychiatric treatment on the 17th hospital day. Although blood purification therapy for acute intoxication is controversial, we herein report a case of surfactant poisoning in which DHP was considered to have contributed to the improvement of circulatory failure.
