A case of acute severe concomitant
poisoning with
narcotic substances of depreciating and psychostimulating action (1,4 - butanediol, 1-phenyl-2- (1-pyrrolidinyl) -1-pentanone, methadone) complicated by the development of severe hypoxic-ischemic changes in the supratentorial white matter of the large brain is presented.
edema and swelling of the brain, nosocomial focal left-sided lower lobe
pneumonia in a 25-year-old patient. Psychoactive substances were used for hedonic purposes. Acute
poisoning occurred after taking 100 ml of
1,4-butanediol together with phenyl-2- (1-pyrrolidinyl) -1-pentanone and 2 g of
methadone, clinically manifested in the form of convulsive syndrome, depression of consciousness to the level of
coma 3,
edema and
swelling brain, acute
respiratory failure, mixed decompensated respiratory and metabolic
lactic acidosis (pH 7.193; partial pressure of
carbon dioxide 62.3 mm Hg,
lactate 7.4 mmol / l) and complications in the form of nosocomial focal left-sided lower lobe
pneumonia. Intensive
therapy was of a complex nature, including infusion-detoxification
therapy, correction of
acid-base state disorders, hypoxic disorders, by using the substrate antihypoxant "
Cytoflavin" in a daily dosage of 60 ml, for 15 days, against the background of basic infusion
therapy and vasopressor support ... The clinical picture of acute
poisoning, the features of its course, the data of radiological diagnostics and the effectiveness of pathogenetic approaches to intensive
therapy are presented.