open access

Vol 50, No 5 (2018)
Review articles
Published online: 2018-11-29
Submitted: 2018-05-13
Accepted: 2018-11-21
Get Citation

Toxicological pitfalls in ICU practice

Tomasz Janus, Krzysztof Pabisiak
DOI: 10.5603/AIT.2018.0042
·
Pubmed: 30615797
·
Anaesthesiol Intensive Ther 2018;50(5):378-383.

open access

Vol 50, No 5 (2018)
Review articles
Published online: 2018-11-29
Submitted: 2018-05-13
Accepted: 2018-11-21

Abstract

Either analgosedation or central nervous system dysfunction may be a side effect of implemented pharmacological
treatment, as well as a consequence of intentional or unintentional poisoning. In traumatic lesions or anoxia of the
central nervous system, a question arises after a recommended follow-up period about the effects of xenobiotics on
nervous system function. Although therapeutic drug monitoring is the gold standard in such cases, usually a single
toxicological estimation of “a neurodepressive compound” is performed after treatment discontinuation in order to
determine the type and amount of exogenous substances, or their metabolites, in a patient’s bodily fluids, which
allows for an assessment of its actual effects on central nervous system functions. The aim of this paper was to describe
the aspects of diagnostic toxicology which are essential for improved determination of the type and amount
of exogenous substances present in biological fluids of intensive care patients. We present examples of clinical cases
in order to discuss the most common discrepancies in interpretation related to the ordering of toxicology tests.

Abstract

Either analgosedation or central nervous system dysfunction may be a side effect of implemented pharmacological
treatment, as well as a consequence of intentional or unintentional poisoning. In traumatic lesions or anoxia of the
central nervous system, a question arises after a recommended follow-up period about the effects of xenobiotics on
nervous system function. Although therapeutic drug monitoring is the gold standard in such cases, usually a single
toxicological estimation of “a neurodepressive compound” is performed after treatment discontinuation in order to
determine the type and amount of exogenous substances, or their metabolites, in a patient’s bodily fluids, which
allows for an assessment of its actual effects on central nervous system functions. The aim of this paper was to describe
the aspects of diagnostic toxicology which are essential for improved determination of the type and amount
of exogenous substances present in biological fluids of intensive care patients. We present examples of clinical cases
in order to discuss the most common discrepancies in interpretation related to the ordering of toxicology tests.

Get Citation

Keywords

xenobiotics, neurodepressants, diagnostic toxicology, ICU treatment , therapeutic drug monitoring

About this article
Title

Toxicological pitfalls in ICU practice

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 50, No 5 (2018)

Pages

378-383

Published online

2018-11-29

DOI

10.5603/AIT.2018.0042

Pubmed

30615797

Bibliographic record

Anaesthesiol Intensive Ther 2018;50(5):378-383.

Keywords

xenobiotics
neurodepressants
diagnostic toxicology
ICU treatment
therapeutic drug monitoring

Authors

Tomasz Janus
Krzysztof Pabisiak

References (9)
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