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Journal of Medical Toxicology

, Volume 9, Issue 1, pp 54–60 | Cite as

A Review of Emergency Cardiopulmonary Bypass for Severe Poisoning by Cardiotoxic Drugs

  • Nicholas J. JohnsonEmail author
  • David F. Gaieski
  • Steven R. Allen
  • Jeanmarie Perrone
  • Francis DeRoos
Review Article

Abstract

Cardiovascular collapse remains a leading cause of death in severe acute drug intoxication. Commonly prescribed medications such as antidysrhythmics, calcium channel antagonists, and beta adrenergic receptor antagonists can cause refractory cardiovascular collapse in massive overdose. Emergency cardiopulmonary bypass (ECPB), a modality originating in cardiac surgery, is a rescue technique that has been successfully implemented in the treatment of refractory cardiogenic shock and cardiac arrest unresponsive to traditional medical interventions. More recently a growing number of animal studies, case reports, and case series have documented its use in refractory hemodynamic collapse in poisoned patients. This article will review current ECPB techniques and explore its growing role in the treatment of severely hemodynamically compromised poisoned patients.

Keywords

Emergency cardiopulmonary bypass Extracorporeal membrane oxygenation Extracorporeal life support Cardiogenic shock Cardiotoxic drugs 

Notes

Conflict of Interest

The authors report no conflicts of interest relevant to this manuscript. Nicholas J. Johnson, Steven R. Allen, Jeanmarie Perrone, and Francis DeRoos have no disclosures. David Gaieski receives research support and consulting fees from Stryker.

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Copyright information

© American College of Medical Toxicology 2012

Authors and Affiliations

  • Nicholas J. Johnson
    • 1
    Email author
  • David F. Gaieski
    • 1
    • 2
  • Steven R. Allen
    • 3
  • Jeanmarie Perrone
    • 1
    • 4
  • Francis DeRoos
    • 1
    • 4
  1. 1.Department of Emergency Medicine, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Center for Resuscitation ScienceUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Department of SurgeryUniversity of PennsylvaniaPhiladelphiaUSA
  4. 4.Division of Medical Toxicology, Department of Emergency Medicine, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA

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