scholarly journals High rate of arterial complications in patients supported with extracorporeal life support for drug intoxication-induced refractory cardiogenic shock or cardiac arrest

2017 ◽  
Vol 9 (7) ◽  
pp. 1988-1996 ◽  
Author(s):  
Matteo Pozzi ◽  
Catherine Koffel ◽  
Camelia Djaref ◽  
Daniel Grinberg ◽  
Jean Luc Fellahi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
High Rate ◽  
Drug Intoxication ◽  
Refractory Cardiogenic Shock ◽  
Arterial Complications

scholarly journals Early Prediction of 3.month Survival of Patients in Refractory Cardiogenic Shock and Cardiac Arrest on Extracorporeal Life Support

2017 ◽  
Vol 21 (3) ◽  
pp. 138-145 ◽  
Author(s):  
Clément Delmas ◽  
Jean-Marie Conil ◽  
Simon Sztajnic ◽  
Bernard Georges ◽  
Caroline Biendel ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Early Prediction ◽  
Refractory Cardiogenic Shock

scholarly journals When all else fails: extracorporeal life support in therapy-refractory cardiogenic shock

2015 ◽  
Vol 49 (3) ◽  
pp. 802-809 ◽  
Author(s):  
Sabina P. W. Guenther ◽  
Stefan Brunner ◽  
Frank Born ◽  
Matthias Fischer ◽  
René Schramm ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Refractory Cardiogenic Shock

scholarly journals Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis

2016 ◽  
Vol 42 (12) ◽  
pp. 1922-1934 ◽  
Author(s):  
Dagmar M. Ouweneel ◽  
Jasper V. Schotborgh ◽  
Jacqueline Limpens ◽  
Krischan D. Sjauw ◽  
A. E. Engström ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Meta Analysis

scholarly journals OUTCOME OF ELDERLY PATIENTS UNDERGOING EXTRACORPOREAL LIFE SUPPORT IN REFRACTORY CARDIOGENIC SHOCK

2017 ◽  
Vol 69 (11) ◽  
pp. 1186
Author(s):  
Suzanne de Waha ◽  
Steffen Desch ◽  
Tobias Graf ◽  
Georg Fuernau ◽  
Ingo Eitel ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Refractory Cardiogenic Shock

scholarly journals Comparison of Mechanical Support with Impella or Extracorporeal Life Support in Post-Cardiac Arrest Cardiogenic Shock: A Propensity Scoring Matching Analysis

2021 ◽  
Vol 10 (16) ◽  
pp. 3583
Author(s):  
Styliani Syntila ◽  
Georgios Chatzis ◽  
Birgit Markus ◽  
Holger Ahrens ◽  
Christian Waechter ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Survival Rates ◽  
Limb Ischemia ◽  
Spontaneous Circulation ◽  
Access Site ◽  
Baseline Characteristics ◽  
Hospital Cardiac Arrest

Our aim was to compare the outcomes of Impella with extracorporeal life support (ECLS) in patients with post-cardiac arrest cardiogenic shock (CS) complicating acute myocardial infarction (AMI). This was a retrospective study of patients resuscitated from out of hospital cardiac arrest (OHCA) with post-cardiac arrest CS following AMI (May 2015 to May 2020). Patients were supported either with Impella 2.5/CP or ECLS. Outcomes were compared using propensity score-matched analysis to account for differences in baseline characteristics between groups. 159 patients were included (Impella, n = 105; ECLS, n = 54). Hospital and 12-month survival rates were comparable in the Impella and the ECLS groups (p = 0.16 and p = 0.3, respectively). After adjustment for baseline differences, both groups demonstrated comparable hospital and 12-month survival (p = 0.36 and p = 0.64, respectively). Impella patients had a significantly greater left ventricle ejection-fraction (LVEF) improvement at 96 h (p < 0.01 vs. p = 0.44 in ECLS) and significantly fewer device-associated complications than ECLS patients (15.2% versus 35.2%, p < 0.01 for relevant access site bleeding, 7.6% versus 20.4%, p = 0.04 for limb ischemia needing intervention). In subgroup analyses, Impella was associated with better survival in patients with lower-risk features (lactate < 8.6 mmol/L, time from collapse to return of spontaneous circulation < 28 min, vasoactive score < 46 and Horowitz index > 182). In conclusion, the use of Impella 2.5/CP or ECLS in post-cardiac arrest CS after AMI was associated with comparable adjusted hospital and 12-month survival. Impella patients had a greater LVEF improvement than ECLS patients. Device-related access-site complications occurred more frequently in patients with ECLS than Impella support.

Multiple Organ Failure and Refractory Cardiogenic Shock due to Venlafaxine Intoxication, Successfully Treated with Veno-Arterial Extracorporeal Life Support

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Painvin B ◽  
◽  
Le Balc’h P ◽  
Gicquel T ◽  
Camus C ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Multiple Organ ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Prolonged Release ◽  
Refractory Cardiogenic Shock

Venlafaxine has critical side effects from arrhythmias to cardiogenic shock after toxic dose ingestion. We report a case of venlafaxine intoxication with Multiple Organ Failure (MOF) treated with Veno-Arterial Extracorporeal Life Support (VA-ECLS). A 60-year old male with a history of chronic depression ingested 72 tablets of prolonged-release venlafaxine hydrochloride 75 mg (total 5400 mg). Initial EKG showed broadened QRS complexes and Transthoracic Echocardiography (TTE) revealed diffuse ventricular hypokinesia with Left Ventricular Ejection Fraction (LVEF) of 15% for which dobutamine infusion was started. Due to persistent refractory cardiogenic shock and MOF, a Medos® Deltastream® VA-ECLS was surgically implanted in our intensive care unit. On day 1, toxicology analysis found plasma concentrations of venlafaxine 3.2mg/L and its metabolite desmethylvenlafaxine at 0.92 mg/L. At day 6, we performed a weaning trial, enabling ECLS removal. Motion defect of anteroseptal and inferolateral walls was also noticed. EKGs showed a shorten R wave in the anteroseptal territory leading to the potential diagnosis of underlying ischemic cardiomyopathy. The patient was extubated at day-10 and discharged for cardiology unit at day-17. At day-20, cardiac magnetic resonance imaging showed no sign of ischemia and TTE parameters were normalized. This is the first report of refractory cardiogenic shock and MOF due to venlafaxine intoxication treated with VA-ECLS. The main objective of ECLS is to restore cardiac output especially when ventricular failure is refractory to inotropes. Our experience suggests that MOF secondary to refractory cardiogenic shock should quickly prompt the implantation of a VA-ECLS in venlafaxine critical overdose.

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