Acute pesticide ingestion managed with yohimbine as a rescue
Case Report:
A 3-year-old child, weighing 12 kg, was admitted with an alleged history of consumption of around 10 ml of 12.5% solution of amitraz 1 h before the presentation. He was dull on presentation and responding to tactile stimuli, with a pulse rate of 59/min and a systolic blood pressure (BP) of 60 mmHg. He was given 0.6 mg intravenous atropine, and his heart rate increased to 134/min and BP to 82/44 mmHg. His clothes were changed, and he was shifted to Intensive Care Unit (ICU). He was obtunded, and bilateral pupils were pinpoint, but other systemic examination revealed no significant findings. An arterial blood gas revealed acute respiratory acidosis (pH 7.24, pCO 2 65, pO 2 105) and he was immediately intubated and started on assisted ventilation. His hemodynamics, oxygen saturation were closely monitored and maintained in normal limits. His laboratory investigations were normal. He was started on yohimbine 2 mg [Figure 1], 8 th hourly through nasogastric tube. He regained full consciousness after 18 h and was weaned off ventilator and was extubated in next 2 h. Yohimbine was continued for 48 h, and he was shifted out of ICU on day 3 and discharged next day....;year=2016;volume=20;issue=12;spage=739;epage=741;aulast=Nasa