PMID- 35353389
OWN - NLM
STAT- MEDLINE
DCOM- 20220420
LR  - 20220420
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 37
IP  - 6
DP  - 2022 Jun
TI  - Veno-arterial extracorporeal membrane oxygenation for drug intoxications: A 
      single center, 14-year experience.
PG  - 1512-1519
LID - 10.1111/jocs.16456 [doi]
AB  - BACKGROUND AND AIM OF THE STUDY: Acute cardiovascular failure remains a leading 
      cause of death in severe poisonings. Veno-arterial extracorporeal membrane 
      oxygenation (VA-ECMO) has been increasingly used as a rescue therapeutic option 
      for those cases refractory to optimal conventional treatment. We sought to 
      evaluate the outcomes after VA-ECMO used for drug intoxications in a 
      single-center experience. METHODS: We performed an observational analysis of our 
      prospective institutional database. The primary endpoint was survival to hospital 
      discharge. RESULTS: Between January 2007 and December 2020, 32 patients (mean 
      age: 45.4 +/- 15.8 years; 62.5% female) received VA-ECMO for drug 
      intoxication-induced refractory cardiogenic shock (n = 25) or cardiac arrest 
      (n = 7). Seven (21.8%) patients developed lower limb ischemia during VA-ECMO 
      support. Twenty-six (81.2%) patients were successfully weaned after a mean 
      VA-ECMO support of 2.9 +/- 1.3 days. One (3.1%) patient died after VA-ECMO weaning 
      for multiorgan failure and survival to hospital discharge was 78.1% (n = 25). 
      In-hospital survivors were discharged from hospital with a good neurological 
      status. Survival to hospital discharge was not statistically different according 
      to sex (male = 75.0% vs. female = 80.0%; p = .535), type of intoxication (single 
      drug = 81.8% vs. multiple drugs = 76.1%; p = .544) and location of VA-ECMO 
      implantation (within our center = 75% vs. peripheral hospital using our Mobile 
      Unit of Mechanical Circulatory Support = 100%; p = .352). Survival to hospital 
      discharge was significantly lower in patients receiving VA-ECMO during on-going 
      cardiopulmonary resuscitation (42.8% vs. 88.0%; p = .026). CONCLUSIONS: VA-ECMO 
      appears to be a feasible therapeutic option with a satisfactory survival rate and 
      acceptable complications rate in poisonings complicated by refractory cardiogenic 
      shock or cardiac arrest.
CI  - (c) 2022 Wiley Periodicals LLC.
FAU - Pozzi, Matteo
AU  - Pozzi M
AUID- ORCID: 0000-0001-6550-0872
AD  - Department of Cardiac Surgery, Louis Pradel Cardiologic Hospital, Claude Bernard 
      University, Lyon, France.
AD  - Research on Healthcare Performance RESHAPE, INSERM U1290, Universite Claude 
      Bernard Lyon 1, Lyon, France.
FAU - Buzzi, Remi
AU  - Buzzi R
AD  - Department of Cardiac Surgery, Louis Pradel Cardiologic Hospital, Claude Bernard 
      University, Lyon, France.
FAU - Hayek, Ahmad
AU  - Hayek A
AD  - Department of Cardiology, Louis Pradel Cardiologic Hospital, Claude Bernard 
      University, Lyon, France.
FAU - Portran, Philippe
AU  - Portran P
AD  - Department of Anesthesia and ICU, Louis Pradel Cardiologic Hospital, Lyon, 
      France.
FAU - Schweizer, Remi
AU  - Schweizer R
AD  - Department of Anesthesia and ICU, Louis Pradel Cardiologic Hospital, Lyon, 
      France.
FAU - Fellahi, Jean Luc
AU  - Fellahi JL
AD  - Department of Anesthesia and ICU, Louis Pradel Cardiologic Hospital, Lyon, 
      France.
FAU - Armoiry, Xavier
AU  - Armoiry X
AD  - Pharmacy Department, School of Pharmacy (ISPB)/UMR CNRS 5510 MATEIS/Edouard 
      Herriot Hospital, University of Lyon, Lyon, France.
FAU - Flagiello, Michele
AU  - Flagiello M
AD  - Department of Cardiac Surgery, Louis Pradel Cardiologic Hospital, Claude Bernard 
      University, Lyon, France.
FAU - Grinberg, Daniel
AU  - Grinberg D
AD  - Department of Cardiac Surgery, Louis Pradel Cardiologic Hospital, Claude Bernard 
      University, Lyon, France.
FAU - Obadia, Jean Francois
AU  - Obadia JF
AD  - Department of Cardiac Surgery, Louis Pradel Cardiologic Hospital, Claude Bernard 
      University, Lyon, France.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20220330
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adult
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Female
MH  - *Heart Arrest/chemically induced/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Shock, Cardiogenic/etiology
OTO - NOTNLM
OT  - cardiac arrest
OT  - cardiogenic shock
OT  - extracorporeal membrane oxygenation
OT  - poisoning
EDAT- 2022/03/31 06:00
MHDA- 2022/04/21 06:00
CRDT- 2022/03/30 12:16
PHST- 2022/01/02 00:00 [revised]
PHST- 2021/11/29 00:00 [received]
PHST- 2022/02/17 00:00 [accepted]
PHST- 2022/03/31 06:00 [pubmed]
PHST- 2022/04/21 06:00 [medline]
PHST- 2022/03/30 12:16 [entrez]
AID - 10.1111/jocs.16456 [doi]
PST - ppublish
SO  - J Card Surg. 2022 Jun;37(6):1512-1519. doi: 10.1111/jocs.16456. Epub 2022 Mar 30.