Preface: When writing this article, the protagonist of this story died due to multiple organ failure and failed rescue efforts. The patient is only 27 years old and is a graduate student majoring in economics and management. It only took 7 days from admission to death. In the top tertiary hospital , the top treatment experts used the most advanced rescue equipment and measures, but they still could not save his life.
has passed away, but the lessons he left behind are worth letting more people know.
A variety of cold medicines
Xiao Zhang (pseudonym) is 27 years old this year and is a graduate student majoring in economics and management.
A week ago, Xiao Zhang suddenly developed a fever. Due to the hot weather, he often went shirtless indoors to blow on the air conditioner. Xiao Zhang didn't pay attention, thinking it might be a common cold.
But after two days, my body temperature did not drop, and I also developed diarrhea.
Xiao Zhang searched online and felt that he had gastrointestinal cold , so he went to the pharmacy to buy cold medicine and took it back. But the reality was different from what Xiao Zhang expected. A week passed and he took a lot of cold medicines. Not only did the fever persist, but the diarrhea was also severe, so he and his mother went to the hospital for treatment.
After arriving at the hospital, the doctor found that there were many abnormalities in Xiao Zhang's blood test. Among them, white blood cells and platelets were reduced to varying degrees. In addition, Xiao Zhang's face was yellowish and he was short of breath, so he persuaded Xiao Zhang to be hospitalized. , for further inspection.
But after Xiao Zhang and his mother heard the doctor's advice, they said: "It's just a cold, just give me some fluids and that's it. Why do you need to be hospitalized?"
However, the outpatient doctor had a positive and responsible attitude and repeatedly persuaded him. Because it can be seen from a simple blood test and Xiao Zhang's face that Xiao Zhang does not have a simple cold.
Fever
The outpatient doctor’s persuasion was ineffective, so he had to call in the director of the respiratory department. When the director of
arrived at the scene, he saw that Xiao Zhang was "tall, obese, with an acute febrile appearance, short of breath, and a sallow complexion." He then looked at the blood routine and found that his white blood cells and platelets were so low that they were close to critical levels.
"You definitely don't have a simple cold. With such low platelets, internal bleeding may occur at any time due to low platelets!" The director sat upright and said seriously.
Perhaps seeing the director’s solemn and serious face and tone, Xiao Zhang’s mother immediately felt that things might not be as simple as they thought, so she agreed to be hospitalized for further examination and treatment.
When Xiao Zhang's mother went to be hospitalized, the director immediately arranged for doctors to measure Xiao Zhang's temperature, ECG monitoring , inhale oxygen, and open a deep vein channel.
As soon as the ECG monitoring results appeared, the doctor panicked: The thermometer showed that Xiao Zhang had a high fever of 40 degrees Celsius. Even high-flow oxygen inhalation could not relieve Xiao Zhang's acute hypoxia. Xiao Zhang's dyspnea symptoms became more and more serious.
's condition far exceeded the doctor's expectations, and as time went by, the condition gradually worsened at a speed visible to the naked eye.
Shortly after being hospitalized, ECG monitoring showed that Xiao Zhang had frequent ventricular premature , and his heart rate was significantly accelerated, which was a sign of myocardial damage; the declining blood pressure prompted Xiao Zhang to gradually start shock ...
Intensive care
"Now Xiao Zhang's condition is getting more and more serious. We need to immediately arrange for him to be placed in the intensive care unit for monitoring and treatment!" The doctor saw Xiao Zhang's condition changing and realized that the situation was very critical, so he immediately called for Xiao Zhang mother talking.
"You are scaring people! How could a cold turn into this?" Xiao Zhang's mother asked in disbelief.
However, the results of further examinations came out quickly, which dispelled Xiao Zhang's mother's doubts: the hematology test showed that Xiao Zhang's muscles were rapidly dissolving, his liver and kidney functions were severely damaged, and his coagulation function was collapsing.
And the bedside color ultrasound showed that Xiao Zhang already had extremely severe fatty liver .
Seeing these critical values, Xiao Zhang’s mother agreed to enter the intensive care unit for monitoring and treatment.
Soon, doctors from the intensive care unit invited the respiratory department, infectious disease department and other departments to consult with Xiao Zhang. They kept discussing that there were eight systems in the human body, and five of Xiao Zhang's systems had collapsed. The cause of Xiao Zhang's multiple organ failure needs to be clarified as soon as possible.
After ice blanket cooling, a large amount of plasma, coagulation factor , and platelet supplementary perfusion treatment, Xiao Zhang's blood pressure was finally maintained.
Liver failure
After Xiao Zhang woke up for a while, the doctor quickly asked: "What kind of cold medicine did you take?"
"I can't remember exactly, but there are several kinds." Xiao Zhang's body was filled with life-sustaining medicines tube, said weakly. "I felt that one type of fever-reducing effect was not obvious, so I bought a few more. The instruction manual said it was based on body weight, so I doubled the amount!"
After further questioning, Xiao Zhang was found to have fatty liver before. In addition, There are no other problems. Obesity has always existed. Before the onset of the disease, I stayed up late for a long time due to the subject. I smoke occasionally and don't drink alcohol.
After listening to Xiao Zhang’s self-report, the doctor’s heart sank.
"It is likely that the combined use of cold medicines caused multiple organ damage!"
"We have to find out what cold medicines Xiao Zhang took quickly!" The doctor immediately found Xiao Zhang's mother and said.
Soon, Xiao Zhang’s mother hurried home and took all the cold medicines that Xiao Zhang had not finished. The doctor saw that they were all common cold medicines on the market. Judging from the ingredients of these cold medicines, they all point to the same substance " acetaminophen "!
Acetaminophen, also known as paracetamol , is a very common antipyretic analgesic on the market. However, in recent years, there have been more and more adverse events related to acetaminophen. Xiao Zhang may have suffered multiple organ failure due to excessive intake of acetaminophen.
In 2014, the US Food and Drug Administration (FDA) issued an announcement restricting doctors' clinical use of cold medicines containing acetaminophen.
Because they believe that excessive use of drugs containing acetaminophen can cause very serious damage to the liver and aggravate liver failure. In some parts of Europe and the United States, many suicide patients choose to use acetaminophen.
Common cold medicines
This shows how "toxic" acetaminophen is!
In the research literature on acetaminophen at home and abroad, we found that:
Adults taking 10~15g (150~250mg/kg) of acetaminophen at one time will cause liver toxicity; 20~25g or higher Dosage may be fatal.
The symptoms of acute acetaminophen poisoning during the first two days do not reflect its severity. Nausea, vomiting, anorexia, and abdominal pain occur within the first 24 hours and may last for several weeks or longer.
Clinical indications of liver injury often become apparent 2 to 4 days after taking a toxic dose.
Plasma aminotransferase increases (sometimes the increase is very obvious), and the concentration of plasma bilirubin also increases; in addition, the prothrombin time is prolonged.
Among poisoned patients without special treatment, 10% may develop severe liver damage, and about 10% to 20% of these patients eventually die of liver failure; some patients may also develop acute renal failure .
After rescuing Xiao Zhang for 48 hours, his condition has not improved much. With consent, Xiao Zhang was transferred to the top intensive care team in the country for continued treatment. There, Xiao Zhang was also detected to be infected with herpes virus .
"Herpes virus infection itself can cause liver damage, and the combined use of several cold medicines leads to an overdose of acetaminophen, which further aggravates liver failure." The treatment team of the top intensive care unit told Xiao Zhang's mother.
The top intensive care unit in the country has a high-level treatment team and the most advanced equipment. However, after staying for 4 days, Xiao Zhang still died due to multiple organ failure and the rescue was ineffective.
Xiao Zhang’s story has sounded the alarm to all of us. Many people may not realize that a small cold medicine can be so harmful after seeing it.
So how to correctly use cold medicine containing acetaminophen?
Cold medicine should be used under the guidance of a doctor or professional pharmacist. Generally speaking, when adults take cold medicine, the content of acetaminophen should not exceed 500 mg at a time, and the interval between doses should not be less than 6 hours.
Do not use several drugs at the same time, as this can easily lead to an overdose of acetaminophen. Check the acetaminophen content before use.
Patients with existing liver diseases, such as cirrhosis, , hepatitis, fatty liver, hepatobiliary stones, or patients with malnutrition, should avoid using cold medicines containing acetaminophen. #HealthTruth Knowledge Plan#
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