Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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Cardiac arrest and severe encephalopathy following e-cigarette nicotine intoxication: a case report

심정지 및 심각한 뇌병변 장애를 초래한 전자 담배용 Nicotine 중독 1례

  • Jinwon Park (Department of Emergency Medicine, Catholic Kwandong University, College of Medicine) ;
  • Sunghyun Yun (Department of Emergency Medicine, Catholic Kwandong University, College of Medicine)
  • 박진원 (가톨릭관동대학교 의과대학 응급의학교실) ;
  • 윤성현 (가톨릭관동대학교 의과대학 응급의학교실)
  • Received : 2022.09.17
  • Accepted : 2022.12.19
  • Published : 2022.12.31
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Abstract

Traditionally, most cases of nicotine poisoning have been due to ingestion of nicotine pesticides. However, the increasing use of electronic cigarettes (e-cigarettes) has resulted in both intentional and unintentional exposure to concentrated liquid nicotine or "e-liquid" leading to an increase in nicotine poisoning cases. However, fatalities following the ingestion of the e-liquid are extremely rare. We report a rare case of cardiac arrest and severe encephalopathy following the intentional ingestion of e-liquid. We present the case of a 20-year-old woman who intentionally ingested liquid nicotine intended for e-cigarette use. She was found in asystole and experienced a return of spontaneous circulation (ROSC) after undergoing approximately 46 mins of cardiopulmonary resuscitation. Her plasma nicotine levels were >500 ng/ml. Despite aggressive supportive care, she was found to have encephalopathy consistent with severe anoxic brain injury on magnetic resonance imaging. In recent times, there have been some reports of deaths following liquid nicotine ingestion. Our case illustrates the potential for fatal nicotine toxicity from ingestion of e-cigarettes.

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References

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