Critical care explorations · 2026
Integrated Use of Extracorporeal Membrane Oxygenation and Molecular Adsorbent Recirculating System for Refractory Cardiotoxic Ingestion: A Single-Center Case Series.
СтатьяКлинический случайНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ehrhardt Tori, Zalesky C Christopher, Shepherd Aaron, Chan Joshua L, Subramanian Ram M, Jabaley Craig S, Morris Melissa, Franco Laura, Miller Casey, Oster Terrance, Nugent Katherine L, Creel-Bulos Christina, Kiernan Emily, Dave Sagar B
Аннотация
BACKGROUND: Cardiotoxic ingestions of calcium-channel blockers and beta-adrenergic antagonists are highly lethal, often causing refractory vasoplegic shock and noncardiogenic pulmonary edema. While venoarterial extracorporeal membrane oxygenation (ECMO) is a recognized rescue therapy for cardiogenic shock, the roles of venovenous ECMO and albumin dialysis-specifically the molecular adsorbent recirculating system (MARS)-as well as the effectiveness of linking patients to therapy through a coordinated referral process remain underexplored.
CASE SUMMARY: We describe five consecutive patients with severe cardiotoxic ingestions managed via a regionally triggered transfer pathway. Patients presented with profound hypotension and respiratory failure despite standard therapies. All five patients received MARS for drug clearance and vasoplegia management; two required venovenous ECMO for refractory hypoxemia. One patient died due to profound myocardial poisoning; four survived to discharge. Complications included continuous renal replacement therapy filter clotting and catheter-associated thrombosis.
CONCLUSIONS: A coordinated regional protocol enabling early access to ECMO and MARS is feasible in massive cardiotoxic ingestions.
CASE SUMMARY: We describe five consecutive patients with severe cardiotoxic ingestions managed via a regionally triggered transfer pathway. Patients presented with profound hypotension and respiratory failure despite standard therapies. All five patients received MARS for drug clearance and vasoplegia management; two required venovenous ECMO for refractory hypoxemia. One patient died due to profound myocardial poisoning; four survived to discharge. Complications included continuous renal replacement therapy filter clotting and catheter-associated thrombosis.
CONCLUSIONS: A coordinated regional protocol enabling early access to ECMO and MARS is feasible in massive cardiotoxic ingestions.