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Extracorporeal Membrane Oxygenation and Cardiopulmonary Bypass in the Poisoned Patient

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Critical Care Toxicology

Abstract

Cardiopulmonary deterioration is a final common pathway of many life-threatening conditions, including those induced by toxins. Despite advances in resuscitation and critical care, severe pulmonary and cardiac failures are associated with a high risk of organ failure and death. Extracorporeal membrane oxygenation (ECMO) is a growing rescue modality for patients with acute reversible life-threatening cardiopulmonary conditions.

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Author information

Authors and Affiliations

  1. Division of Medical Toxicology, Department of Emergency Medicine Carolinas Medical Center, Charlotte, NC, USA

    William P. Kerns II

  2. Department of Internal Medicine, Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC, USA

    Alan C. Heffner

Authors
  1. William P. Kerns II
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  2. Alan C. Heffner
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Corresponding authors

Correspondence to William P. Kerns II or Alan C. Heffner .

Editor information

Editors and Affiliations

  1. Department of Medicine, Division of Clinical Pharmacology and Toxicology, University of Colorado, School of Medicine, Aurora, Colorado, USA

    Jeffrey Brent

  2. FDA, Office of New Drugs/Immediate Office, Center for Drug Evaluation and Research, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas’ Hospital, Silver Spring, Maryland, USA

    Paul Dargan

  4. Toxicology Associates, University of Colorado, School of Medicine, Denver, Colorado, USA

    Benjamin Hatten

  5. Medical Toxicological Intensive Care Unit, Lariboisiere Hospital, Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. Toxicology Associates, University of Colorado, School of Medicine, Denver, Colorado, USA

    Robert Palmer

  7. Toxinology Department, Women’s and Children’s Hospital, North Adelaide, South Australia, Australia

    Julian White

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Kerns, W.P., Heffner, A.C. (2017). Extracorporeal Membrane Oxygenation and Cardiopulmonary Bypass in the Poisoned Patient. In: Brent, J., et al. Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-17900-1_91

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