Journal of Clinical Toxicology
Open Access
ISSN: 2161-0495
+44 1478 350008
ISSN: 2161-0495
+44 1478 350008
Youichi Yanagawa, Yohei Hirano, Masaaki Takemoto, Tetsuhiro Takei, Toshitaka Ito and Toshiaki Iba
Purpose: To clarify the characteristics of AKA patients with visual disturbances.
Material and methods: An Ichushi and Pubmed search was undertaken to identify articles that reported patients with visual disturbances due to AKA. The clinical data in the articles were reviewed. This study also performed a subanalysis by classifying the patients with visual disturbance due to AKA into two groups: an arrest group, which experienced cardiac arrest during hospitalization and a no-arrest group, which did not.
Results: There were 12 case reports describing patients with visual disturbances due to AKA. There were 14 patients who showed a visual disturbance due to AKA. There were 11 males and 3 females. The range of age was from 44 to 68, with an average of 55 years old. Seven cases had loss of consciousness and the systolic blood pressure of in 12 cases was under 90 mmHg. All cases show arterial blood gas pH under 6.90 and severe metabolic acidosis. All but one of the visual disturbance cases improved after correction of acidemia by infusion of sodium bicarbonate or blood purification. Six cases experienced cardiac arrest during their hospitalization. Three cases finally died. The subanalysis showed the average pH on arrival in the arrest group was lower than that in the no-arrest group (6.63 vs. 6.75, respectively). And the survival ratio in the arrest group was smaller than that in the no-arrest group (50 vs. 100%, respectively).
Conclusion: Severe AKA was associated with visual disturbances, which could be cured by correction of acidosis. In addition, patients with severe AKA with a pH on arterial gas analysis under 6.70 tended to experience cardiac arrest and the patients with arrest had a poor prognosis. Physicians should understand how to treat such patients.