@article{ref1,
title="Continuous levosimendan infusion for refractory cardiogenic shock complicating severe acute dichlorvos poisoning",
journal="American journal of the medical sciences",
year="2012",
author="Liu, Y. and Liu, B. and Zhou, H. and Wei, L.-q.",
volume="344",
number="2",
pages="166-170",
abstract="Respiratory failure is the leading cause of death after organophosphorus poisoning. Cardiac complications are rare, serious and little known to clinicians. The authors present a case of a 74-year-old man with refractory cardiogenic shock after taking 200 mL of 80% dichlorvos for a suicide attempt. This study represents the first reported cardiogenic shock resulting from organophosphorus poisoning in the literature, clarifying its hemodynamic features with invasive hemodynamic monitoring (PiCCO; Pulsion Medical Systems AG, Munich, Germany). Additional levosimendan infusion was commenced after insufficient conventional therapies, resulting in an increase in cardiac power index by 236% and a decrease in systemic vascular resistance by 69% after 24 hours of continuous infusion. Despite the immense hemodynamic improvement after levosimendan treatment, the patient died of multiple organ failure 6 days after admission. The authors also discussed the inotropic and vasodilatory effects of levosimendan in this clinical scenario. © 2012 Lippincott Williams & Wilkins.<p /><p>Language: en</p>",
language="en",
issn="0002-9629",
doi="10.1097/MAJ.0b013e318254490d",
url="http://dx.doi.org/10.1097/MAJ.0b013e318254490d"
}