Intoxication with a barium salt can result in a number of clinical and laboratory findings.
Barium salts include barium acetate, barium chlorate, barium chloride, barium fluoride, barium hexafluorosilicate, barium hydroxide, barium polysulfide, barium sulfide.
Barium carbonate is a rodenticide that is a common cause of barium poisoning (discussed above).
Classic diagnostic triad:
(1) acute abdominal upset with abdominal pain and watery diarrhea
(2) severe hypokalemia
(3) muscle weakness
Other clinical findings:
(1) excessive salivation
(2) nausea and vomiting
(3) cirumoral and peripheral paresthesias
(4) decreased deep tendon reflexes (DTR)
(5) headache
(6) confusion
(7) pulmonary edema
(8) myclonus and/or muscle rigidity
(9) myalgias
(10) dysarthrias
(11) flaccid paralysis
(12) mydriasis
(13) hypertension
Clinical findings in severe intoxications:
(1) seizures
(2) respiratory failure
(3) acute renal failure
(4) cardiac arrest
ECG findings:
(1) premature ventricular contractions (PVCs)
(2) atrioventricular dissociation
(3) QRS widening
(4) QT prolongation
(5) ventricular tachycardia
(6) ventricular fibrillation
(7) bradycardia
Laboratory findings:
(1) profound hypokalemia
(2) lactic acidosis
(3) elevated serum and urine barium concentrations
Specialty: Toxicology, Emergency Medicine, Critical Care