Dobutamine in the treatment of severe scorpion envenoming.

This study was conducted in the medical surgical ICU of Habib Bourguiba University Hospital in Sfax - Tunisia. We included 21 patients with pulmonary edema or hemodynamic shock following scorpion envenoming. All patients were monitored using Swan-Ganz catheter. After a first check of the hemodynamic parameters (baseline), all patients received dobutamine infusion at 5, 10, and 15 μg/kg/min. The median age of patients was 19 years (IQR: 14-26) and 12 patients (57.1%) were males. On ICU admission, 11 patients (52.4%) had shock, all patients (100%) had pulmonary edema, 20 patients (95.2%) had neurologic manifestations, and 16 patients (76.2%) had gastro-intestinal manifestations. During ICU stay, 18 patients (85.7%) received mechanical ventilation (MV). The median duration of MV was 3 days (IQR: 2-4). The median duration of dobutamine administration was 4 days (IQR: 3-5). Cardiac index at baseline was 2.7 L/min/m2 (IQR: 2.3-3.2). Under dobutamine at 5, 10 and 15 μg/kg/min, it was 3.6 (IQR: 3.2-3.9), 4.0 (IQR: 2.9-4.8), and 4.1 (IQR: 3.6-4.9) respectively. Arterio-venous oxygen difference at baseline was 6.0 ml/dl (IQR: 5.0-7.0). Under dobutamine at 5, 10 and 15 μg/kg/min, it was 6.1 (IQR: 4.7-6.4), 3.9 (IQR: 3.4-4.3), and 3.9 (IQR: 3.1-4.7) respectively. The length of stay in ICU was 4 days (IQR: 4-5) and 2 patients died during ICU stay (9.5%). Our study confirms that cardiac dysfunction following scorpion envenomation in Tunisia improved well and safely under dobut...
Source: Toxicon - Category: Toxicology Authors: Tags: Toxicon Source Type: research