Case report: veno-venous ECMO as a bridge to lung transplantation in paraquat poisoning
3 out of 5 stars
Successful extracorporeal membrane oxygenation therapy as a bridge to sequential bilateral lung transplantation for a patient after severe paraquat poisoning. Tang X et al. Clin Toxicol 2015 Aug 28 [Epub ahead of print]
Abstract
Conceptually, extracorporeal membrane oxygenation (ECMO) seems a perfect technique for treating some of the sickest toxicology patients, buying time until failing vital functions can recover.
With severe cardiotoxins — for example, calcium channel blockers, beta blockers or bupropion — veno-arterial ECMO can provide complete cardiopulmonary bypass, replacing both cardiac and pulmonary function.
In the case of severe poisoning with paraquat — a highly toxic herbicide that causes progressive respiratory failure and irreversible pulmonary fibrosis — veno-venous ECMO can replace support pulmonary function and serve as a bridge to lung transplantation.
This paper from Beijing Chao-Yang Hospital describes what is, to my knowledge, the first case in which v-v ECMO has been used successfully to treat paraquat poisoning. A 24-year-old, 53-kg woman ingested an estimated 50 ml of 20% paraquat.She arrived at hospital 2 hours later and was initially treated with gastric lavage, laxatives, and activated charcoal. Additional treatment included cyclosphophamide, steroids, and hemoperfusion. Unfortunately, her initial signs and symptoms are not well-described.
Three days after presentation, the patient was transferred 1500 km to a tert...
Source: The Poison Review - Category: Toxicology Authors: Leon Tags: Medical ECMO extracorporeal membrane oxygenation lung transplantation paraquat poisoning Source Type: news
More News: Beta-Blockers | Bupropion | Calcium | Cardiology | Celexa | Citalopram | Emergency Medicine | Gastric Lavage | Gastroenterology | Heart | Hospitals | Lung Transplant | Podcasts | Poisoning | Psychology | Rehabilitation | Respiratory Medicine | Toxicology | Transplant Surgery | Transplants | Websites | Wellbutrin