Synthetic Cannabinoid-Associated Multiple Organ Failure: Case Series and Literature Review

Pharmacotherapy
Faith ArmstrongMojdeh S Heavner

Abstract

We describe a multicenter descriptive case series of six patients admitted with synthetic cannabinoid (SC) intoxication displaying similar symptoms and sequelae, all resulting in multiple organ failure. Patients were included in this report if they presented with known SC use and experienced multiple organ failure between March 1, 2016, and July 19, 2016, to the intensive care units of three hospitals in Maryland. Patients were followed to either discharge or death, and complications related to SC were documented. All six patients presented with altered mental status and severe rhabdomyolysis, with a peak creatine phosphokinase ranging from 4000 to >320,000 units/L. The majority of patients (five of six) presented with acute kidney injury, with most (four of six) requiring continuous renal replacement therapy. Most patients experienced fever (five of six) and myocardial injury, as evidenced by a troponin elevation (three of six). Seizures occurred in half of patients (three of six patients). Two patients required emergent fasciotomies of the bilateral lower extremities for acute compartment syndrome. Two patients developed fulminant hepatic failure that necessitated liver transplant evaluation, one requiring Molecular Adsorbent...Continue Reading

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Citations

Feb 23, 2020·Critical Care Nursing Quarterly·Kent A OwusuJeffrey Mucksavage
Oct 9, 2019·International Journal of Environmental Research and Public Health·Jürgen RehmBundit Sornpaisarn
Feb 14, 2020·International Journal of Molecular Sciences·Monia LenziMatteo Marti
Apr 7, 2020·Archives of Toxicology·Dino Luethi, Matthias E Liechti
Jan 9, 2021·Therapeutic Advances in Psychopharmacology·Abu ShafiDerek K Tracy
Apr 17, 2021·Journal of Analytical Toxicology·Shiyang QinJianghai Lu

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