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Zhu-Xi Yu, Yang Pi, Mei-Kai Chen, Dan-Jiang Dong, Qin Gu Department of Critical Care Medicine, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, 21008, People’s Republic of ChinaCorrespondence: Qin Gu, Department of Critical Care Medicine, the Affiliated Drum Tower Hospital of Nanjing University Medical school, Nanjing, Jiangsu, 21008, People’s Republic of China, Tel +86-13705150348, Email guqin123456202206@163.comAbstract: Hemodynamic instability in patients with clozapine intoxication can indirectly reflect the serum concentration of clozapine.We have described a case of a 32-year-old pregnant woman who developed life-threatening clozapine toxicity at 28 weeks of gestation. The levels of clozapine and norclozapine in the serum were high. We initiated hemoperfusion(HP) and other detoxification therapies to remove the drug. The patient had severely dilated peripheral blood vessels, which led to cardiac symptoms such as fatal hypotension and uncontrollable tachycardia, resulting in very high cardiac output and elevated Central venous oxygen saturation (ScvO2). Pharmacological intervention significantly improved the hemodynamics.In light of our observations in the ongoing case, we posit that evaluating hemodynamic parameters before and after blood detoxification could serve as a valuable means to gauge effectiveness and provide guidance for treatment.Keywords: clozapine, toxicity, pulse index continuous cardiac output, PICCO, hemoperfusion, HP |
