Successful treatment of life-threatening ventricular tachycardia with high-dose propranolol under extracorporeal life support and intraaortic balloon pumping.

Kawasaki disease is usually a limited illness of early childhood. However, life-threatening cardiac manifestations can occur, either at acute presentation or as a consequence of coronary arterial involvement. We report the successful use of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) for cardiac support in two children with Kawasaki disease: one with acute Kawasaki disease shock syndrome, the other with complications of coronary arteritis and subsequent surgery. We also reviewed the reported experience in the ELSO database and available literature.

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Clinical Toxicology of Yew Poisoning

Annals of Pharmacotherapy ◽

10.1177/1060028017754225 ◽

2018 ◽

Vol 52 (6) ◽

pp. 591-599 ◽

Cited By ~ 1

Author(s):

Alexander W. Labossiere ◽

Dennis F. Thompson

Keyword(s):

English Language ◽

Life Support ◽

Extracorporeal Life Support ◽

Case Reports ◽

Data Extraction ◽

Case Series ◽

Therapeutic Interventions ◽

Plant Materials ◽

Search Terms ◽

Life Threatening

Objectives: Yew plant materials contain highly toxic taxine alkaloids. Serious ingestions can result in life-threatening toxicity. The purpose of this article is to summarize the literature on the treatment of acute yew poisoning. Data Sources: PubMed (January 1946 to November 2017) was searched using the search terms “taxus/po”. EMBASE (1980 to November 2017) was searched using the search terms “taxus/to” and “yew.mp.” Web of Science (1945 to November 2017) was searched using the text words taxus, taxine, and yew. Study Selection and Data Extraction: Available English language articles involving case reports, epidemiology, treatment, and outcomes were included. Data Synthesis: Although not uncommon, unintentional yew poisoning rarely results in significant morbidity or mortality. A total of 26 case reports of yew poisoning were evaluated along with 4 case series articles (totaling 22 additional cases). Only 4 of the 48 total cases (8%) were accidental poisonings, the rest being deliberate ingestions. In 20 patients (42%), it resulted in fatalities. Severe, acute yew poisoning results in symptomatology largely resistant to pharmacotherapy intervention. Conclusions: Most nonintentional ingestions of yew plant constituents are asymptomatic and require little intervention. Severe poisoning can result in life-threatening cardiac toxicity and require aggressive supportive care. Therapeutic interventions, such as sodium bicarbonate, digoxin immune fab, and hemodialysis that have been utilized in case studies and case series in the literature have little proven benefit. Extracorporeal life support should be considered in severe yew poisoning.

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Acute Respiratory Distress Syndrome After Zinc Chloride Inhalation: Survival After Extracorporeal Life Support and Corticosteroid Treatment

American Journal of Critical Care ◽

10.4037/ajcc2009908 ◽

2010 ◽

Vol 19 (1) ◽

pp. 86-90 ◽

Cited By ~ 19

Author(s):

Chih-Feng Chian ◽

Chin-Pyng Wu ◽

Chien-Wen Chen ◽

Wen-Lin Su ◽

Chin-Bin Yeh ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Life Support ◽

Extracorporeal Life Support ◽

Corticosteroid Treatment ◽

High Dose ◽

Arterial Oxygenation ◽

Bilateral Pneumothorax

No standard protocol exists for the treatment of acute respiratory distress syndrome induced by inhalation of smoke from a smoke bomb. In this case, a 23-year-old man was exposed to smoke from a smoke grenade for approximately 10 to 15 minutes without protective breathing apparatus. Acute respiratory distress syndrome developed subsequently, complicated by bilateral pneumothorax and pneumomediastinum 48 hours after inhalation. Despite mechanical ventilation and bilateral tube thoracostomy, the patient was severely hypoxemic 4 days after hospitalization. His condition improved upon treatment with high-dose corticosteroids, an additional 500-mg dose of methylprednisolone, and the initiation of extracorporeal life support. Arterial oxygenation decreased gradually after abrupt tapering of the corticosteroid dose and discontinuation of the life support. On day 16 of hospitalization, the patient experienced progressive deterioration of arterial oxygenation despite the intensive treatment. The initial treatment regimen (ie, corticosteroids and extracorporeal life support) was resumed, and the patient’s arterial oxygenation improved. The patient survived.

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Successful treatment of fulminant pulmonary embolism with extracorporeal life support and simultaneous systemic thrombolytic therapy after 1 h of cardiopulmonary resuscitation

General Thoracic and Cardiovascular Surgery ◽

10.1007/s11748-013-0338-x ◽

2013 ◽

Vol 63 (12) ◽

pp. 664-666

Author(s):

Hiroyuki Kamiya ◽

Hug Aubin ◽

Payam Akhyari ◽

Roland Walz ◽

Diyar Saeed ◽

...

Keyword(s):

Pulmonary Embolism ◽

Cardiopulmonary Resuscitation ◽

Thrombolytic Therapy ◽

Successful Treatment ◽

Life Support ◽

Extracorporeal Life Support ◽

Systemic Thrombolytic Therapy

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Nearly Fatal Hydroxychloroquine Overdose Successfully Treated with Midazolam, Propofol, Sodium Bicarbonate, Norepinephrine, and Intravenous Lipid Emulsion

Case Reports in Emergency Medicine ◽

10.1155/2021/8876256 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Goswin Onsia ◽

Sarah Bots

Keyword(s):

Sodium Bicarbonate ◽

Lipid Emulsion ◽

Life Support ◽

Extracorporeal Life Support ◽

Scientific Evidence ◽

Treatment Options ◽

Cardiac Monitoring ◽

High Dose ◽

Epinephrine Infusion ◽

Intravenous Lipid Emulsion

Background. In the context of the current COVID-19 pandemic, there has been renewed interest in the drug hydroxychloroquine. However, clinicians should be aware of the dangers of hydroxychloroquine intoxication, an insufficiently studied condition. Case Report. We present a case of autointoxication with 20 g hydroxychloroquine in a 35-year-old woman. Cardiac monitoring showed ventricular arrhythmias for which high-dose midazolam and propofol were initiated, resulting in a brief normalization of the cardiac rhythm. Because of the reoccurrence of these arrhythmias, intravenous lipid emulsion was administered with fast cardiac stabilization. Treatment with continuous norepinephrine, potassium chloride/phosphate, and sodium bicarbonate was initiated. On day 6, she was extubated and after 11 days, she was discharged from the hospital without complications. Conclusion. Since high-quality scientific evidence is lacking, treatment options are based on experience in chloroquine toxicity. Activated charcoal is advised if the patient presents early. Sedation with diazepam, early ventilation, and continuous epinephrine infusion are considered effective in treating severe intoxication. Caution is advised when substituting potassium. Despite the lack of formal evidence, sodium bicarbonate appears to be useful and safe in case of QRS widening. Intravenous lipid emulsion, with or without hemodialysis, remains controversial but appears to be safe. As a last resort, extracorporeal life support might be considered in case of persisting hemodynamic instability.

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Extracorporeal Life Support for Massive Hemoptysis and Acute Lung Injury Due to ANCA Negative Vasculitis

Journal of Anaesthesia and Critical Care Reports ◽

10.13107/jaccr.2021.v07i01.165 ◽

2021 ◽

Vol 7 (1) ◽

Keyword(s):

Acute Lung Injury ◽

Lung Injury ◽

Extracorporeal Membrane Oxygenation ◽

Respiratory Distress ◽

Life Support ◽

Extracorporeal Life Support ◽

Rescue Therapy ◽

Massive Hemoptysis ◽

Life Threatening

Massive hemoptysis is life-threatening and extracorporeal membrane oxygenation (ECMO) may be indicated as rescue therapy due to acute lung injury in this setting. We report a case of a patient who presented with massive hemoptysis and acute lung injury after reported inhaled ground oxymorphone abuse. Although initially thought to have been due to inhaled oxymorphone, we determined that the patient had ANCA-negative vasculitis that led to both hemoptysis and hematuria. The role of inhaled oxymorphone in combination with the vasculitis is unknown. ECMO was initiated to support the patient and, although his course was complicated, he did recover. Keywords: ECMO; Vasculitis; Acute Respiratory Distress (ARDS).

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Vitamin D deficiency cardiomyopathy in Scotland: a retrospective review of the last decade

Archives of Disease in Childhood ◽

10.1136/archdischild-2019-317794 ◽

2020 ◽

Vol 105 (9) ◽

pp. 853-856

Author(s):

Lindsay Hunter ◽

Richard Ferguson ◽

Helen McDevitt

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Retrospective Review ◽

Life Support ◽

Extracorporeal Life Support ◽

Case Series ◽

High Serum ◽

High Dose ◽

Cardiac Transplant ◽

Total Body Calcium

ObjectiveTo determine the incidence, demography and prognosis of vitamin D deficiency dilated cardiomyopathy (DCM) in Scotland over the last decade.Study designA retrospective review of cases of vitamin D deficiency DCM presenting to a national paediatric cardiac centre between 1 January 2008 and 1 January 2018. The departmental database and electronic and paper case notes were used to identify patients and extract data.ResultsSix patients were identified (three male), three of whom were Caucasian. Median age at presentation was 206 days (range 2–268.) All six patients had high serum parathyroid hormone levels (median 45 pmol/L, range 27–120 pmol/L), a sensitive marker of total body calcium deprivation secondary to vitamin D deficiency. All patients demonstrated clinical and echocardiographic improvement following high dose vitamin D treatment. No patients required cardiac transplant, and only one patient required extracorporeal life support as a bridge to recovery. After an initial improvement, one child died at 5 months as a result of respiratory infection. Three patients lived within some of the most deprived areas in Scotland.ConclusionsThis case series demonstrates a previously unreported demographic in Scotland, as 50% of cases presented in Caucasian children. Although vitamin D deficiency DCM is relatively rare, it is wholly preventable. Our study confirms that vitamin D deficiency cardiomyopathy is reversible with prompt identification and supplementation. The current implementation of public health policy in the UK is failing to prevent children from developing the most severe manifestation of vitamin D deficiency.

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