Extracorporeal bypass for the treatment of verapamil poisoning

Hendren, William G.; Schieber, Richard S; Garrettson, Lorne K.

doi:10.1016/s0196-0644(89)80465-2

Cited by 70 publications

(42 citation statements)

References 23 publications

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“…These early studies showed improved mortality in models of lidocaine and amitriptyline poisoning [11,12]. Numerous human case reports and case series have since shown favorable outcomes although ECMO has been primarily used in poisonings involving pharmaceuticals such as antidysrhythmics and other cardiovascular medications, as well as tricyclic antidepressants [13][14][15][16][17][18][19][20][21][22][23][24][25]. Many of the pharmaceutical exposures in our cohort were similar to cases reported in the literature with most leading to cardiotoxicity or hemodynamic collapse (flecainide, diphenhydramine, and verapamil).…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation (ECMO) for Severe Toxicological Exposures: Review of the Toxicology Investigators Consortium (ToxIC)

et al. 2015

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Although there have been many developments related to specific strategies for treating patients after poisoning exposures, the mainstay of therapy remains symptomatic and supportive care. One of the most aggressive supportive modalities is extracorporeal membrane oxygenation (ECMO). Our goal was to describe the use of ECMO for toxicological exposures reported to the American College of Medical Toxicology (ACMT) Toxicology Investigators Consortium (Tox-IC). We performed a retrospective review of the ACMT ToxIC Registry from January 1, 2010 to December 31, 2013. Inclusion criteria included patients aged 0 to 89 years, evaluated between January 2010 through December 2013, and received ECMO for toxicological exposure. There were 26,271 exposures (60 % female) reported to the ToxIC Registry, 10 (0.0004 %) received ECMO: 4 pediatric (< 12 years), 2 adolescent (12-18 years), and 4 adults (>18 years). Time of initiation of ECMO ranged from 4 h to 4 days, with duration from 15 h to 12 days. Exposures included carbon monoxide/smoke inhalation (2), bitter almonds, methanol, and several medications including antihistamines (2), antipsychotic/ antidepressant (2), cardiovascular drugs (2), analgesics (2), sedative/hypnotics (2), and antidiabetics (2). Four ECMO patients received cardiopulmonary resuscitation (CPR) during their hospital course, and the overall survival rate was 80 %. ECMO was rarely used for poisoning exposures in the ACMT ToxIC Registry. ECMO was utilized for a variety of ages and for pharmaceutical and non-pharmaceutical exposures. In most cases, ECMO was administered prior to cardiovascular failure, and survival rate was high. If available, ECMO may be a valid treatment modality.

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Section: Discussionmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation (ECMO) for Severe Toxicological Exposures: Review of the Toxicology Investigators Consortium (ToxIC)

et al. 2015

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“…Medidas adicionales de manejo como marcapaso cardiaco; balón de contra pulsación intraáortico, oxigenación por membrana extracorpórea (ECMO); plasmaféresis y hemofiltración pueden usarse en toxicidad refractaria (2,7,8).…”

Section: Discussionunclassified

Amlodipino y choque vasodilatado en una unidad de cuidados intensivos de un hospital general. Reporte de caso

Zegarra¹,

Meza²,

Cornejo³

et al. 2017

Rev Med Hered

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“…A 25-month-old toddler initially stabilized after being placed on cardiopulmonary bypass following verapamil ingestion. Levels rose again, however, after discontinuation of the procedure, and the patient subsequently died [48]. In contrast, a 41-year-old man survived to discharge without sequelae after institution of emergent bypass for intentional verapamil ingestion [49].…”

Section: Managementmentioning

confidence: 97%