Successful Extracorporeal Life Support in a Case of Severe Glyphosate-Surfactant Intoxication

Chan, Cheng-Wei; Wu, I‐Lin; Lee, Ching-Hsing; Hsu, Shou-Chien; Liao, Shih‐Chieh

doi:10.1097/ccm.0000000000001352

Cited by 8 publications

(10 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The successful use of ECMO in the treatment of adult poisoned and trauma patients has been previously described in case reports and small case series. 2,3,5–14,16,19 In our case series we successfully employed ECMO in five patients following suspected or confirmed suicide attempts. All five patients were discharged from the hospital, but some had prolonged courses with complications.…”

Section: Discussionmentioning

confidence: 99%

“…ECMO has been used successfully to support patients following suicide attempts. 2,3 Both veno-arterial (VA) and veno-venous (VV) ECMO have been employed for cardiotoxic ingestions 5–13 and poisoning complicated by respiratory failure 14 , respectively, and in trauma patients without suicide attempts who develop acute respiratory distress syndrome (ARDS) or thoracic organ contusion. 15–18 A retrospective cohort analysis of 62 patients following drug intoxication (intentional and unintentional) compared the use of ECMO in 14 patients to conventional medical therapy in 48 patients and suggested a survival benefit in the ECMO group.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Examining the role of extracorporeal membrane oxygenation in patients following suspected or confirmed suicide attempts: A case series

Abbasi

Devers

Muratore

et al. 2018

Journal of Critical Care

View full text Add to dashboard Cite

The decision to offer extracorporeal membrane oxygenation (ECMO) is based on a risk/benefit assessment and the likelihood of a treatable underlying condition or the feasibility of destination therapy (durable mechanical support or thoracic organ transplantation) should heart-lung function fail to improve. Patients who present following suspected suicide attempts who fail medical therapy may pose a dilemma for clinicians. An assessment to determine if a patient has a high likelihood of psychiatric recovery such that bridging with ECMO or ultimately destination therapy could or should be offered is not always feasible in the setting of critical illness. This case series reviews our institution's experience with ECMO in the management of five patients who presented following suspected or confirmed suicide attempts. All five patients survived to hospital discharge. Two had subsequent psychiatric admissions, one following a repeat suicide attempt. A discussion of these cases demonstrates the effectiveness of ECMO in supporting this group of patients in the short-term. The self-limited natural history of many psychiatric episodes, poisonings and traumatic injuries makes the use of ECMO a potentially reasonable support strategy. However, careful consideration must be given to psychiatric history and follow-up given the substantial commitment of resources, potential for complications and for stranding patients on extracorporeal therapy without definitive destination therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Examining the role of extracorporeal membrane oxygenation in patients following suspected or confirmed suicide attempts: A case series

Abbasi

Devers

Muratore

et al. 2018

Journal of Critical Care

View full text Add to dashboard Cite

show abstract

“…With the removal of the organophosphorus pesticides, cardiac function can be restored by the application of ECMO. Therefore, we recommend that for patients with refractory cardiogenic shock caused by AOPP, ECMO should be implemented early after the failure of conventional therapy [18,19] .…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Severe Myocardial Injury Complicated With Refractory Cardiogenic Shock Caused by AOPP Using Extracorporeal Membrane Oxygenation

Li¹,

Cao²,

Luo³

et al. 2020

Preprint

View full text Add to dashboard Cite

Acute organophosphorus pesticide poisoning (AOPP) is a common critical illness observed in clinical practice, and severe AOPP can cause serious cardiac toxicity. We report a case of severe myocardial injury caused by AOPP complicated with refractory cardiogenic shock that was successfully rescued with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) therapy. We suggest that for patients with severe myocardial injury complicated with cardiogenic shock following AOPP, the use of VA-ECMO therapy can improve the prognosis.

show abstract

“…However, we still lack experience regarding the role of ECMO in the treatment of diquat and glyphosate poisoning, with few case reports. [12,15,16] It has been reported that ECMO was effective for patients with glyphosate poisoning complicated with cardiovascular and respiratory damage.…”

Section: Discussionmentioning

confidence: 99%

Successful extracorporeal membrane oxygenation support for severe acute diquat and glyphosate poisoning

Wang

Zhang

et al. 2019

Medicine

View full text Add to dashboard Cite

Rationale: Because of the lack of an antidote or effective treatment, patients with severe acute diquat and glyphosate poisoning always died within a few hours. Extracorporeal membrane pulmonary oxygenation (ECMO), as an artificial heart-lung supporting system, can be applied to support lung that is expected to recover from reversible pathological damage. However, to our knowledge, the application of ECMO for patients with diquat and glyphosate poisoning has not been reported. Patient concerns: A 40-year-old man ingested in 100 ml of diquat (20 g/100 ml) and 400 ml glyphosate (41 g/100 ml) was admitted to the intensive care unit (ICU), immediately complicated by the development of ventricular fibrillation, respiratory failure, renal failure, and multi-organ failure. Diagnosis: Diquat and glyphosate poisoning were diagnosed by stated ingestion history, and the diagnostic criteria for acute respiratory distress syndrome (ARDS) and multi-organ dysfunction syndrome were also met. Interventions: He was treated with veno-venous ECMO. Outcomes: He was successfully transferred out of the ICU on day 46 and discharged on day 67. The computed tomography scan showed no obvious pulmonary fibrosis 2 months after poisoning. Lessons: ECMO may be effective in the treatment of patients with severe ARDS caused by diquat and glyphosate poisoning when conventional management does not work.

show abstract

Successful Extracorporeal Life Support in a Case of Severe Glyphosate-Surfactant Intoxication

Cited by 8 publications

References 14 publications

Examining the role of extracorporeal membrane oxygenation in patients following suspected or confirmed suicide attempts: A case series

Examining the role of extracorporeal membrane oxygenation in patients following suspected or confirmed suicide attempts: A case series

Successful Treatment of Severe Myocardial Injury Complicated With Refractory Cardiogenic Shock Caused by AOPP Using Extracorporeal Membrane Oxygenation

Successful extracorporeal membrane oxygenation support for severe acute diquat and glyphosate poisoning

Contact Info

Product

Resources

About