Podcast: Managing the crashing tox patient with ECMO

As I wrote about in a recent column for Emergency Medicine News, extracorporeal membrane oxygenation (ECMO) may be the next big thing in managing the severely ill, crashing overdose patient in whom usual therapy is not working. On the new podcast posted today at the EDECMO website, Steve Aks and I got together over Skype with Joe Bellezzo, Zack Shinar, and Scott Weingart to discuss the potential benefits, as well as the potential risks and complications, involved in using ECMO in the sickest tox patients. Some of the topics we discuss: What overdose patients might benefit most from ECMO? What vascular access is needed for ECMO?  Would ECMO be effective in treating poisoning from agents such as carbon monoxide and cyanide that are not primarily cardiodepressants? Should ECMO and lipid reduce therapy be done simultaneously? Can hemodialysis be done safely in a patient on ECMO, and if so can the dialysis circuit be in series with the ECMO pathway? To listen to the podcast, click here. Here are links to some of the papers mentioned during our discussion, and even more recent literature: Bellezzo J et al. Emergency physician-initiated extracorporeal cardiopulmonary resuscitation. Resuscitation 2012 Aug;83:966-70. De Lange DW et al. Extracorporeal membrane oxygenation in the treatment of poisoned patients. Clin Toxicol 2013 Jun;51:385-393. Escajeda JT et al. Successful treatment of metoprolol-induced cardiac arrest with high-dose insulin, lipid emulsion, and extracorporeal me...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical ECMO edecmo extracorporeal membrane oxygenation podcast poisoning toxicology Source Type: news