tailieunhanh - Báo cáo khoa học: "Clinical review: Aggressive management and extracorporeal support for drug-induced cardiotoxicity"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Clinical review: Aggressive management and extracorporeal support for drug-induced cardiotoxicity. | Available online http content 11 2 207 Review Clinical review Aggressive management and extracorporeal support for drug-induced cardiotoxicity Frédéric J Baud1 Bruno Megarbane1 Nicolas Deye1 and Pascal Leprince2 1 Medical and Toxicological Intensive Care Unit Assistance Publique-Hôpitaux de Paris University Paris 7 Hôpital Lariboisière 75010 Paris France 2Department of Cardiovascular and Thoracic Surgery Assistance Publique-Hôpitaux de Paris University Paris 6 Hôpital Pitié Salpétrière 75013 Paris France Corresponding author Frédéric Baud Published 12 March 2007 Critical Care 2007 11 207 doi cc5700 This article is online at http content 11 2 207 2007 BioMed Central Ltd Abstract Poisoning may induce failure in multiple organs leading to death. Supportive treatments and supplementation of failing organs are usually efficient. In contrast the usefulness of cardiopulmonary bypass in drug-induced shock remains a matter of debate. The majority of deaths results from poisoning with membrane stabilising agents and calcium channel blockers. There is a need for more aggressive treatment in patients not responding to conventional treatments. The development of new antidotes is limited. In contrast experimental studies support the hypothesis that cardiopulmonary bypass is life-saving. A review of the literature shows that cardiopulmonary bypass of the poisoned heart is feasible. The largest experience has resulted from the use of peripheral cardiopulmonary bypass. However a literature review does not allow any conclusions regarding the efficiency and indications for this invasive method. Indeed the majority of reports are single cases with only one series of seven patients. Appealing results suggest that further studies are needed. Determination of prognostic factors predictive of refractoriness to conventional treatment for cardiotoxic poisonings is mandatory. These prognostic factors are specific for a toxicant or a .