Severe bupropion overdose and ECMO: two great saves
ChaNaWiT/shutterstock.com
3.5 out of 5 stars
Two Cases of Refractory Cardiogenic Shock Secondary to Bupropion Successfully Treated with Veno-Arterial Extracorporeal Membrance Oxygenation. Heise CW et al. J Med Toxicol 2016 Feb 8 [Epub Ahead of Print]
Abstract
This awesome, exciting paper from Banner University Medical Center in Phoenix describes two teenagers with severe bupropion overdose who survived refractory cardiac arrest after veno-arterial extracorporeal membrane oxygenation (VA-ECMO):
Case 1: A 15-year-old girl was brought to hospital after ingesting up to 90 150-mg bupropion tablets. She had a seizure en route and arrived with pulseless electrical activity (PEA). Return of spontaneous circulation was achieved after 20 minutes of cardiopulmonary resuscitation. She was sent by air-ambulance to a tertiary hospital with a Medical Toxicology service. During transport, she had recurrent episodes of PEA.
At the receiving hospital, the patient had progressive hypoxia and decreased cardiac output with an ejection fraction < 25% on echocardiogram. Because of her worsening condition, VA-ECMO was instituted.
After 4 days, her myocardial function improved but she developed pulmonary hemorrhage and was changed to veno-venous ECMO. She had full recovery after a total of 10 days on veno-arterial and veno-venous ECMO. A follow-up echocardiogram showed an ejection fraction of 60-65%.
A serum bupropion level drawn before ECMO was started was 1883 ng/ml (therapeutic, 50-100 ng/ml...
Source: The Poison Review - Category: Toxicology Authors: Leon Tags: Medical burpropion ECMO extracorporeal membrane oxygenation Source Type: news
More News: Bupropion | Cardiogenic Shock | Cardiology | Cardiovascular | Diprivan | Emergency Medicine | Girls | Heart | Hospitals | Overdose | Phenobarbital | Poisoning | Propofol | Rhabdomyolysis | Toxicology | Wellbutrin