tailieunhanh - Báo cáo y học: "Extra-corporeal life support for near-fatal multi-drug intoxication: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Extra-corporeal life support for near-fatal multi-drug intoxication: a case report. | Rona et al. Journal of Medical Case Reports 2011 5 231 http content 5 1 231 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Extra-corporeal life support for near-fatal multi-drug intoxication a case report 1 1 1 22 1 Roberto Rona Barbara Cortinovis Roberto Marcolin Nicolò Patroniti Stefano Isgrò Chiara Marelli and Roberto Fumagalli2 Abstract Introduction Severe mixed p-blocker and calcium channel blocker intoxication presents a significant risk for patient mortality. Although treatment is well-established it sporadically fails to support the patient through massive overdoses thus requiring non-conventional treatments. We report the use of extra-corporeal life support in a patient with refractory hemodynamic impairment due to multi-drug intoxication. Although sometimes used in clinical practice extra-corporeal membrane oxygenation for intoxications has rarely been reported. Case presentation A 36-year-old Caucasian man presented to our hospital with refractory hypotension severe cardiac insufficiency and multi-organ failure due to mixed intoxication with atenolol nifedipine Lacidipine and sertraline. Together with standard treatment we performed extra-corporeal membrane oxygenation to overcome refractory cardiogenic shock and lead the patient to achieve a full recovery. Conclusion Standard of care for p-blocker and calcium channel blocker intoxication is well-defined and condensed into protocols of treatment. Although aimed at clearing the noxious agents from the patient s system standard measures may fail to provide adequate hemodynamic support to allow recovery. In selected cases extracorporeal membrane oxygenation could be considered a bridge to drug clearance while preventing multi-organ failure due to profound shock. Introduction p-blocker BB and calcium channel blocker CCB are the most common cardiovascular medication classes reported in the database of the American Association of Poison Control Centers Toxic Exposure .