Acute Barium Intoxication and Hemodiafiltration

Koch, Marc; Appoloni, Olivier; Haufroid, Vincent; Vincent, Jean Louis; Lheureux, Philippe

doi:10.1081/clt-120022004

Cited by 27 publications

(30 citation statements)

References 13 publications

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“…Intravenous magnesium and potassium chloride are used to correct hypomagnesaemia and hypokalaemia, respectively. Renal replacement therapy (intermittent haemodialysis [9]-[11] or continuous venovenous haemodiafiltration [3] shortens the half-life of barium and is reported to be effective in severe barium poisoning and should be considered early in the management.…”

Section: Discussionmentioning

confidence: 99%

“…Peak serum level occurs 2 hours after ingestion with an elimination half life of 3.6 days. The systemic effects of Barium are linked with two modes of action: direct muscular stimulation (skeletal, cardiac, and smooth), and hypokalaemia [3,4]. The latter effect is associated with the ability of the barium ion to block potassium (K+) channels and interfere with passive K+ diffusion [4,5].…”

Section: Introductionmentioning

confidence: 99%

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Mass barium carbonate poisoning with fatal outcome, lessons learned: a case series

Ghose

Sayeed

Hossain

et al. 2009

Cases J

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IntroductionBarium, a heavy divalent alkaline metal, has long been known to cause human toxicity. The common mode is accidental ingestion and the common compound is Barium carbonate. Here we report an incident of food poisoning in 27 law enforcement personnel with rapidly developing sequelae and a high mortality due to ingestion of Barium carbonate contaminated flour.Case presentationOne midnight, 27 adult males were rushed to emergency department of Chittagong Medical College Hospital with abdominal pain, vomiting, loose motion, cramps and generalized paraesthesia. The ailment started 1-2 hours after Iftar (evening meal to break day long fast during Ramadan) which included fried vegetables coated with a flour paste. On admission, twenty of them were restless, agitated. 22 reported weakness of limbs and were unable to walk. 10 had hypotension. 22 had rapid and shallow respiration. 5 had carpopedal spasm. Different grades of limb weakness were noted with loss of tendon jerks. Ten (N12) patients had hypokalaemia, three had hypoglycaemia, 4 patients had high creatine kinase. ECG showed flat ST with U waves in 4 patients. Potassium containing intravenous fluid and Oxygen was administered. Due to limited availability of mechanical ventilators patients were put on artificial respiration using Ambu bag; manually maintained by doctors, paramedics and attendants. Four patients were transferred to another hospital for mechanical ventilation. A total of 12 patients died over next 16 hours, 4 within 3 hrs. Other patients gradually improved. Chemical analysis of the vomitus, blood and flour used for preparation of meal revealed the presence of Barium. It was assumed that the flour was contaminated with the similar looking Barium carbonate powder which was kept in the kitchen as a rodenticide.ConclusionThis event exemplifies the weakness of usual health care facility in resource poor settings to cope with this kind of massive poisoning event. The multiple reported incidences of accidental barium poisoning due to unintentional mixing with food signifies the fact that the use and availability of barium carbonate should be restricted. We hope to draw attention to this relatively uncommon poisoning and to the need for development of poison information centre in resource poor countries.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mass barium carbonate poisoning with fatal outcome, lessons learned: a case series

Ghose

Sayeed

Hossain

et al. 2009

Cases J

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“…Barium poisoning causes rapid hypokalemia, resulting in cardiac dysrhythmias, muscles weakness and respiratory failure [5–10]. Rhabdomyolysis and increased lactate levels have also been observed [5,7,8,10].…”

Section: Introductionmentioning

confidence: 99%

“…Rhabdomyolysis and increased lactate levels have also been observed [5,7,8,10]. Most barium salts are well absorbed from the gastrointestinal tract; barium sulfate used in oral radiographic contrast is insoluble and therefore not absorbed.…”

Section: Introductionmentioning

confidence: 99%

Acute barium toxicity from ingestion of “snake” fireworks

Rhyee

Heard

2009

J. Med. Toxicol.

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Introduction Ingestion of fireworks has been infrequently reported in the medical literature. We describe a case of acute, severe barium poisoning following firework ingestion. Case Report A 35 year-old male with a history of severe mental retardation presented with vomiting and diarrhea following ingestion of 16 small fireworks (“color snakes” and “black snakes”). His condition rapidly deteriorated and he developed obtundation, wide complex dysrhythmias and respiratory failure. Approximately 12 hours following ingestion his serum potassium level was 1.5 mmol/L with a serum barium level of 20, 200 mcg/mL (reference range < 200 mcg/L). The patient eventually recovered with ventilatory support and potassium supplementation. Discussion Although firework ingestion is uncommon, clinicians should be prepared for potentially severe complications. In the case of barium poisoning, treatment consists of potassium supplementation and respiratory and hemodynamic support.

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“…Downloaded from www.nrcresearchpress.com by San Francisco (UCSF) on 11/26/14 ing power, especially at small spatial and temporal scales, the assumptions that marking has no effect on marked individuals requires closer examination. It has been established in multiple taxa that exposure to high quantities of barium and strontium can have lethal effects (Dietz et al 1992;Morohashi et al 1994;Koch et al 2003); however, the sublethal effects of minute doses of these elements have yet to be thoroughly evaluated. In the present study, we found that the effects of transgenerational marking with 20-40 g·g −1 of enriched stable 137 Ba and 87 Sr on larvae of M. adspersa varied among morphological traits, growth, and survival.…”

Section: Figmentioning

confidence: 99%

Maternally transmitted isotopes and their effects on larval fish: a validation of dual isotopic marks within a meta-analysis context

Starrs

Davis

Schlaefer

et al. 2014

Can. J. Fish. Aquat. Sci.

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Transgenerational marking enables mass-marking of larval fishes via transmission of enriched stable isotopes from mother to offspring, but potential impacts on the resultant progeny are poorly understood. We injected enriched stable isotopes ( 137 Ba and 87 Sr) into female purple-spotted gudgeon, Mogurnda adspersa, to produce multiple batch markers and examined larval morphology at hatch as well as survival and growth to 31 days posthatch in marked and unmarked offspring. Transgenerational marking had minimal effects on larval growth and survival, whereas body depth at hatch was significantly reduced in marked larvae. A meta-analysis of transgenerational marking effects on larval morphology at hatch and growth rates across multiple fish species found a nonsignificant positive effect of enriched stable barium isotopes on larval morphology at hatch, but a significant negative effect on growth. There were no significant effects of strontium on morphology or growth. Meta-regression analysis revealed that larval size at hatch increased with the dose of injected stable barium isotopes, but this result should be interpreted cautiously. Because of high levels of between-study heterogeneity, we caution against assuming there are no effects of transgenerational marking on fish offspring; any such effects should be validated and incorporated into transgenerational marking studies of fish dispersal.Résumé : Si la méthode de marquage transgénérationnel permet le marquage d'un grand nombre de larves de poisson par la transmission d'isotopes stables enrichis de la mère à sa progéniture, ses impacts potentiels sur cette progéniture demeurent mal compris. Nous avons injecté des isotopes stables enrichis ( 137 Ba et 87 Sr) dans une femelle de Mogurnda adspersa pour produire différents marqueurs de lot et avons examiné la morphologie, la survie et la croissance de larves marquées et non marquées 31 jours après leur éclosion. Si le marquage transgénérationnel a eu peu d'effets sur la croissance et la survie des larves, la profondeur du corps au moment de l'éclosion était significativement plus faible pour les larves marquées. Une méta-analyse des effets du marquage transgénérationnel sur la morphologie des larves à l'éclosion et les taux de croissance pour différentes espèces de poisson a révélé un effet positif non significatif sur la morphologie des larves à l'éclosion, mais un effet négatif significatif sur la croissance, attribuable à l'enrichissement des isotopes stables de baryum. Aucun effet significatif du strontium sur la morphologie ou la croissance n'a été décelé. L'analyse de méta-régression a révélé que la taille des larves à l'éclosion augmentait parallèlement à la dose d'isotopes stables de baryum injectée, mais ce résultat devrait être interprété avec prudence. En raison des degrés élevés d'hétérogénéité entre les études, il est recommandé de ne pas présumer que le marquage transgé-nérationnel n'a aucun effet sur la progéniture de poisson, la présence de tels effets devant préalablement être validée, puis incorporée ...

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Acute Barium Intoxication and Hemodiafiltration

Cited by 27 publications

References 13 publications

Mass barium carbonate poisoning with fatal outcome, lessons learned: a case series

Mass barium carbonate poisoning with fatal outcome, lessons learned: a case series

Acute barium toxicity from ingestion of “snake” fireworks

Maternally transmitted isotopes and their effects on larval fish: a validation of dual isotopic marks within a meta-analysis context

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