Successful management of severe acute respiratory distress syndrome caused by sodium polystyrene sulfonate aspiration: A case report

Research output: Contribution to journalArticle

Abstract

RATIONALE: Sodium polystyrene sulfonate is commonly administered to treat hyperkalemia. Severe pneumonia due to aspiration of this drug is rare and no survival case has thus far been reported. PATIENT CONCERNS: A 45-year-old man was hospitalized for acute decompensated heart failure and acute kidney injury with hyperkalemia. He aspirated sodium polystyrene sulfonate while consuming the drug. Severe acute respiratory distress syndrome (ARDS) developed rapidly, and he was transferred to the intensive care unit (ICU). DIAGNOSES: Chest radiography results after aspiration showed new consolidation in the left upper lung. He underwent emergency bronchoscopy, which revealed a considerable amount of yellow mud-like material in the trachea and bronchi. Chest radiography results after the bronchoscopic removal of the foreign material revealed rapid resolution of the left upper lung consolidation. INTERVENTIONS: In the ICU, mechanical ventilation with low tidal volume and high positive end-expiratory pressure was administered and extracorporeal membrane oxygenation (ECMO) was set up for treating severe ARDS. We arranged an emergency bronchoscopy for diagnosis and removal of polystyrene sulfonate. OUTCOMES: ECMO was discontinued after 10 days and the patient was discharged after approximately 2 weeks. LESSONS: Aspiration of sodium polystyrene sulfonate is not common but can be lethal. Clinicians should be cautious and appropriately inform patients of the aspiration risk while administering this drug. Mechanical ventilation and bronchoscopy were effective treatments for severe ARDS caused by aspiration of this drug.

Original languageEnglish
Pages (from-to)e16574
JournalMedicine
Volume98
Issue number30
DOIs
Publication statusPublished - 2019 Jul 1

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Severe Acute Respiratory Syndrome
Adult Respiratory Distress Syndrome
Bronchoscopy
Extracorporeal Membrane Oxygenation
Hyperkalemia
Artificial Respiration
Radiography
Pharmaceutical Preparations
Intensive Care Units
Emergencies
Thorax
Lung
Positive-Pressure Respiration
Tidal Volume
Bronchi
Trachea
Acute Kidney Injury
Pneumonia
Heart Failure
Survival

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Successful management of severe acute respiratory distress syndrome caused by sodium polystyrene sulfonate aspiration: A case report",
abstract = "RATIONALE: Sodium polystyrene sulfonate is commonly administered to treat hyperkalemia. Severe pneumonia due to aspiration of this drug is rare and no survival case has thus far been reported. PATIENT CONCERNS: A 45-year-old man was hospitalized for acute decompensated heart failure and acute kidney injury with hyperkalemia. He aspirated sodium polystyrene sulfonate while consuming the drug. Severe acute respiratory distress syndrome (ARDS) developed rapidly, and he was transferred to the intensive care unit (ICU). DIAGNOSES: Chest radiography results after aspiration showed new consolidation in the left upper lung. He underwent emergency bronchoscopy, which revealed a considerable amount of yellow mud-like material in the trachea and bronchi. Chest radiography results after the bronchoscopic removal of the foreign material revealed rapid resolution of the left upper lung consolidation. INTERVENTIONS: In the ICU, mechanical ventilation with low tidal volume and high positive end-expiratory pressure was administered and extracorporeal membrane oxygenation (ECMO) was set up for treating severe ARDS. We arranged an emergency bronchoscopy for diagnosis and removal of polystyrene sulfonate. OUTCOMES: ECMO was discontinued after 10 days and the patient was discharged after approximately 2 weeks. LESSONS: Aspiration of sodium polystyrene sulfonate is not common but can be lethal. Clinicians should be cautious and appropriately inform patients of the aspiration risk while administering this drug. Mechanical ventilation and bronchoscopy were effective treatments for severe ARDS caused by aspiration of this drug.",
author = "Ko, {Cheng Yu} and Liu, {Ping Yen} and Chen, {Po Wei}",
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Successful management of severe acute respiratory distress syndrome caused by sodium polystyrene sulfonate aspiration : A case report. / Ko, Cheng Yu; Liu, Ping Yen; Chen, Po Wei.

In: Medicine, Vol. 98, No. 30, 01.07.2019, p. e16574.

Research output: Contribution to journalArticle

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AB - RATIONALE: Sodium polystyrene sulfonate is commonly administered to treat hyperkalemia. Severe pneumonia due to aspiration of this drug is rare and no survival case has thus far been reported. PATIENT CONCERNS: A 45-year-old man was hospitalized for acute decompensated heart failure and acute kidney injury with hyperkalemia. He aspirated sodium polystyrene sulfonate while consuming the drug. Severe acute respiratory distress syndrome (ARDS) developed rapidly, and he was transferred to the intensive care unit (ICU). DIAGNOSES: Chest radiography results after aspiration showed new consolidation in the left upper lung. He underwent emergency bronchoscopy, which revealed a considerable amount of yellow mud-like material in the trachea and bronchi. Chest radiography results after the bronchoscopic removal of the foreign material revealed rapid resolution of the left upper lung consolidation. INTERVENTIONS: In the ICU, mechanical ventilation with low tidal volume and high positive end-expiratory pressure was administered and extracorporeal membrane oxygenation (ECMO) was set up for treating severe ARDS. We arranged an emergency bronchoscopy for diagnosis and removal of polystyrene sulfonate. OUTCOMES: ECMO was discontinued after 10 days and the patient was discharged after approximately 2 weeks. LESSONS: Aspiration of sodium polystyrene sulfonate is not common but can be lethal. Clinicians should be cautious and appropriately inform patients of the aspiration risk while administering this drug. Mechanical ventilation and bronchoscopy were effective treatments for severe ARDS caused by aspiration of this drug.

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