Extracorporeal Membrane Oxygenation and Cardiopulmonary Bypass in the Poisoned Patient

  • William P. KernsII
  • Alan C. Heffner
Reference work entry


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.


Extracorporeal membrane oxygenation Cardiopulmonary bypass ECMO Extracorporeal life support Hypoxemia Acute respiratory distress syndrome ARDS Cardiopulmonary failure Calcium channel antagonists Sodium channel antagonist Cardiopulmonary resuscitation ß-adrenergic blockers Respiratory failure Paraquat Colchicine Chloroquine Cyclophosphamide Bupropion Taxine Organ donation Intravenous fat emulsion Lipid rescue Extracorporeal drug elimination 


  1. 1.
    Shekar K, Fraser JF, Smith MT, Roberts JA. Pharmacokinetic changes in patients receiving extracorporeal membrane oxygenation. J Crit Care. 2012;27:741.e9–18.CrossRefGoogle Scholar
  2. 2.
    Nasr DM, Rabinstein AA. Neurologic complications of extracorporeal membrane oxygenation. J Clin Neurol. 2015;11:383–9.PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Brogan TV, Thiagarajan RR, Rycus PT, Bartlett RH, Bratton SL. Extracorporeal membrane oxygenation in adults with severe respiratory failure: a multi-center database. Intensive Care Med. 2009;35:2105–14.PubMedCrossRefGoogle Scholar
  4. 4.
    Zangrillo A, Landoni G, Biondi-Zoccai G, Greco M, Greco T, Frati G, Patroniti N, Antonelli M, Pesenti A, Pappalardo F. A meta-analysis of complications and mortality of extracorporeal membrane oxygenation. Crit Care Resusc. 2013;15:172–8.PubMedGoogle Scholar
  5. 5.
    Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM, Hibbert CL, Truesdale A, Clemens F, Cooper N, Firmin RK, Elbourne D. CESAR trial collaboration. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet. 2009;374:1351–63.PubMedCrossRefGoogle Scholar
  6. 6.
    Combes A, Brodie D, Bartlett R, Brochard L, Brower R, Conrad S, De Backer D, Fan E, Ferguson N, Fortenberry J, Fraser J, Gattinoni L, Lynch W, MacLaren G, Mercat A, Mueller T, Ogino M, Peek G, Pellegrino V, Pesenti A, Ranieri M, Slutsky A, Vuylsteke A. The International ECMO Network (ECMONet). Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients. Am J Resp Crit Care Med. 2014;190:488–96.PubMedCrossRefGoogle Scholar
  7. 7.
    Beurtheret S, Mordant P, Paoletti X, Marijon E, Celermajer DS, Léger P, Pavie A, Combes A, Leprince P. Emergency circulatory support in refractory cardiogenic shock patients in remote institutions: a pilot study (the cardiac-RESCUE program). Eur Heart J. 2013;34:112–20.PubMedCrossRefGoogle Scholar
  8. 8.
    Allen S, Holena D, McCunn M, Kohl B, Sarani B. A review of the fundamental principles and evidence base in the use of extracorporeal membrane oxygenation (ECMO) in critically Ill adult patients. J Intensive Care Med. 2011;26:13–26.PubMedCrossRefGoogle Scholar
  9. 9.
    Schmidt M, Pellegrino V, Combes A, Scheinkestel C, Cooper DJ, Hodgson C. Mechanical ventilation during extracorporeal membrane oxygenation. Crit Care. 2014;18:203.PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Brodie D, Bacchetta M. Extracorporeal membrane oxygenation for ARDS in adults. N Engl J Med. 2011;365:1905–14.PubMedCrossRefGoogle Scholar
  11. 11.
    Cardarelli MG, Young AJ, Griffith B. Use of extracorporeal membrane oxygenation for adults in cardiac arrest (E-CPR): a meta-analysis of observational studies. ASAIO J. 2009;55:581–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Haneya A, Philipp A, Diez C, Schopka S, Bein T, Zimmermann M, Lubnow M, Luchner A, Agha A, Hilker M, Hirt S, Schmid C, Muller T. A 5-year experience with cardiopulmonary resuscitation using extracorporeal life support in non-postcardiotomy patients with cardiac arrest. Resuscitation. 2012;83:1331–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Rooney M, Massey KL, Jamali F, Rosin M, Thomson D, Johnson DH. Acebutolol overdose treated with hemodialysis and extracorporeal membrane oxygenation. J Clin Pharmacol. 1996;36:760–3.PubMedCrossRefGoogle Scholar
  14. 14.
    Moreno J, Magaldi M, Fontanals J, Gómez L, Berne P, Berruezo A, Brugada J. Use of therapeutic hypothermia and extracorporeal life support after an unusual response to the ajmaline challenge in a patient with Brugada syndrome. J Cardiol Cases. 2014;10:34–8.CrossRefGoogle Scholar
  15. 15.
    Haas NA, Wegendt C, Schäffler R, Kirchner G, Welisch E, Kind K, Blanz U, Kececioglu D. ECMO for cardiac rescue in a neonate with accidental amiodarone overdose. Clin Res Cardiol. 2008;97:878–81.PubMedCrossRefGoogle Scholar
  16. 16.
    Benassi F, Molardi A, Righi E, Santangelo R, Meli M. ECMO for pulmonary rescue in an adult with amiodarone-induced toxicity. Heart Vessels. 2015;30:410–5.PubMedCrossRefGoogle Scholar
  17. 17.
    Weinberg RL, Bouchard NC, Abrams DC, Bacchetta M, Dzierba AL, Burkart KM, Brodie D. Venoarterial extracorporeal membrane oxygenation for the management of massive amlodipine overdose. Perfusion. 2014;29:53–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Koschny R, Lutz M, Seckinger J, Schwenger V, Stremmel W, Eisenbach C. Extracorporeal life support and plasmapheresis in a case of severe polyintoxication. J Emerg Med. 2014;47:527–31.PubMedCrossRefGoogle Scholar
  19. 19.
    Lai MW, Boyer EW, Kleinman ME, Rodig NM, Ewald MB. Acute arsenic poisoning in two siblings. Pediatrics. 2005;116:249–57.PubMedCrossRefGoogle Scholar
  20. 20.
    Heise CW, Beutler D, Bosak A, Orme G, Loli A, Graeme K. Massive atenolol, lisinopril, and chlorthalidone overdose treated with endoscopic decontamination, hemodialysis, impella percutaneous left ventricular assist device, and ECMO. J Med Toxicol. 2015;11:110–4.PubMedCrossRefGoogle Scholar
  21. 21.
    Bilbault P, Pynn S, Mathien C, Mazzucotelli JP, Schneider F, Jaeger A. Near-fatal betaxolol self-poisoning treated with percutaneous extracorporeal life support. Eur J Emerg Med. 2007;14:120–2.PubMedCrossRefGoogle Scholar
  22. 22.
    Long WB, Rosenblum S, Grady IP. Successful resuscitation of bupivacaine-induced cardiac arrest using cardiopulmonary bypass. Anesth Analg. 1989;69:403–6.PubMedGoogle Scholar
  23. 23.
    Shenoi AN, Gertz SJ, Mikkilineni S, Kalyanaraman M. Refractory hypotension from massive bupropion overdose successfully treated with extracorporeal membrane oxygenation. Pediatr Emerg Care. 2011;27:43–5.PubMedCrossRefGoogle Scholar
  24. 24.
    Heise CW, Skolnik AB, Raschke RA, Owen-Reece H, Graeme KA. Two cases of refractory cardiogenic shock secondary to bupropion successfully treated with veno-arterial extracorporeal membrane oxygenation. J Med Toxicol. 2016;12:301–304Google Scholar
  25. 25.
    Mégarbane B, Leprince P, Deye N, Guerrier G, Résière D, Bloch V, Baud FJ. Extracorporeal life support in a case of acute carbamazepine poisoning with life-threatening refractory myocardial failure. Intensive Care Med. 2006;32:1409–13.PubMedCrossRefGoogle Scholar
  26. 26.
    McCunn M, Reynolds HN, Cottingham CA, Scalea TM, Habashi NM. Extracorporeal support in an adult with severe carbon monoxide poisoning and shock following smoke inhalation: a case report. Perfusion. 2000;15:169–73.PubMedCrossRefGoogle Scholar
  27. 27.
    Haesendonck R, de Winter S, Verelst S, Sabbe MB. Intravenous lipid emulsion for intentional chloroquine poisoning. Clin Toxicol. 2012;50:223.CrossRefGoogle Scholar
  28. 28.
    De Vroey F, Plein D, Vercauteren S, Castadot M, Bettendorf P. Rescue extracorporeal circulation in fulminant cocaine-induced heart failure. Int J Cardiol. 2009;133:e111–3.PubMedCrossRefGoogle Scholar
  29. 29.
    Boisramé-Helms J, Rahmani H, Stiel L, Tournoud C, Sauder P. Extracorporeal life support in the treatment of colchicine poisoning. Clin Toxicol. 2015;53:827–9.Google Scholar
  30. 30.
    Jouffroy R, Lamhaut L, Soldan MP, Vivien B, Philippe P, An K, Carli P. A new approach for early onset cardiogenic shock in acute colchicine overdose: place of early extracorporeal life support (ECLS)? Intensive Care Med. 2013;39:1163.PubMedCrossRefGoogle Scholar
  31. 31.
    Lainé M, Mourissoux G, Camou F. Early onset cardiogenic shock in acute colchicine overdose. J Clin Toxicol. 2012;2:5.CrossRefGoogle Scholar
  32. 32.
    Meserve EE, Lehmann LE, Perez-Atadye AR, Labelle JL. Cyclophosphamide-associated cardiotoxicity in a child after stem cell transplantation for β-Thalassemia Major: case report and review of the literature. Pediatr Dev Pathol. 2014;17:50–4.PubMedCrossRefGoogle Scholar
  33. 33.
    Goodwin DA, Lally KP, Null DM. Extracorporeal membrane oxygenation support for cardiac dysfunction from tricyclic antidepressant overdose. Crit Care Med. 1993;21:625–7.PubMedCrossRefGoogle Scholar
  34. 34.
    Behringer W, Sterz F, Domanovits H, Schoerkhuber W, Holzer M, Foedinger M, Laggner AN. Percutaneous cardiopulmonary bypass for therapy resistant cardiac arrest from digoxin overdose. Resuscitation. 1998;37:47–50.PubMedCrossRefGoogle Scholar
  35. 35.
    Durward A, Guerguerian AM, Lefebvre M, Shemie SD. Massive diltiazem overdose treated with extracorporeal membrane oxygenation. Pediatr Crit Care Med. 2003;4:372–6.PubMedCrossRefGoogle Scholar
  36. 36.
    Frazee EN, Lee SJ, Kalimullah EA, Personett HA, Nelson DR. Circulatory support with venoarterial ECMO unsuccessful in aiding endogenous diltiazem clearance after overdose. Case Rep Crit Care. 2014. doi:10.1155/2014/969578Google Scholar
  37. 37.
    Pizon AF, Brooks DE. Fentanyl patch abuse: naloxone complications and extracorporeal membrane oxygenation rescue. Vet Hum Toxicol. 2004;46:256–7.PubMedGoogle Scholar
  38. 38.
    Auzinger GM, Scheinkestel CD. Successful extracorporeal life support in a case of severe flecainide intoxication. Crit Care Med. 2001;29:887–90.PubMedCrossRefGoogle Scholar
  39. 39.
    Corkeron MA, van Heerden PV, Newman SMAJ, Dusci L. Extracorporeal circulatory support in near-fatal flecainide overdose. Anaesth Intensive Care. 1999;27:405–8.PubMedGoogle Scholar
  40. 40.
    Kwan D, Vohra R, Dyer JE, Dornhoffer P. An infant with a heartbreaking medication error. Pediatr Emerg Care. 2014;30:e1–5.PubMedCrossRefGoogle Scholar
  41. 41.
    Sivalingam SK, Gadiraju VT, Hariharan MV, Atreya AR, Flack JE, Aziz H. Flecainide toxicity – treatment with intravenous fat emulsion and extra corporeal life support. Acute Cardiol Care. 2013. doi:10.3109/17482941.2013.841949Google Scholar
  42. 42.
    Yasui RK, Culclasure TF, Kaufman D, Freed CR. Flecainide overdose: is cardiopulmonary support the treatment? Ann Emerg Med. 1997;29:680–2.PubMedCrossRefGoogle Scholar
  43. 43.
    Schmitt C, Klouche K, Machado S, Tichadou L, de Haro L. Beta-blocker and flecainide overdoses induced by Amanita proxima poisoning. Clin Toxicol. 2012;50:288.Google Scholar
  44. 44.
    Vivien B, Deye N, Mégarbane B, Marx JS, Leprince P, Bonnet N, Roussin F, Jacob L, Pavie A, Baud FJ, Carli P. Extracorporeal life support in a case of fatal flecainide and betaxolol poisoning allowing successful cardiac allograft. Ann Emerg Med. 2010;56:409–12.PubMedCrossRefGoogle Scholar
  45. 45.
    Rateesh S, Shekar K, Naidoo R, Mittal D, Bhaskar B. Use of extracorporeal membrane oxygenation for mechanical circulatory support in a patient with 5-fluorouracil induced acute heart failure. Circ Heart Failure. 2015;8:381–3.PubMedCrossRefGoogle Scholar
  46. 46.
    Adolph V, Heaton J, Steiner R, Bonis S, Falterman K, Arensman R. Extracorporeal membrane oxygenation for nonneonatal respiratory failure. J Pediatr Surg. 1991;26:326–32.PubMedCrossRefGoogle Scholar
  47. 47.
    Chyka PA. Benefits of extracorporeal membrane oxygenation for hydrocarbon pneumonitis. Clin Toxicol. 1996;34:357–63.Google Scholar
  48. 48.
    Scalzo AJ, Weber TR, Jaeger RH, Connors RH, Thompson MW. Extracorporeal membrane oxygenation for hydrocarbon aspiration. Am J Dis Child. 1990;144:867–71.PubMedGoogle Scholar
  49. 49.
    Marciniak KE, Thomas IH, Brogan TV, Roberts JS, Czaja A, Mazor SS. Massive ibuprofen overdose requiring extracorporeal membrane oxygenation for cardiovascular support. Pediatr Crit Care Med. 2007;8:180–2.PubMedCrossRefGoogle Scholar
  50. 50.
    Williams JM, Hollingshed MJ, Vasilakis A, Morales M, Prescott JE, Graeber GM. Extracorporeal circulation in the management of severe tricyclic antidepressant overdose. Am J Emerg Med. 1994;12:456–8.PubMedCrossRefGoogle Scholar
  51. 51.
    Garrettson LK, McGee EB. Rapid onset of seizures following aspiration of viscous lidocaine. J Toxicol Clin Toxicol. 1992;30:413–22.PubMedCrossRefGoogle Scholar
  52. 52.
    Gilbert CR, Baram M, Cavarocchi NC. “Smoking wet” – respiratory failure related to smoking tainted marijuana cigarettes. Tex Heart Inst J. 2013;40:64–7.PubMedPubMedCentralGoogle Scholar
  53. 53.
    Froehle M, Haas N, Kirchner G, Kececioglu D, Sandica E. ECMO for cardiac arrest after accidental intravenous mepivacaine application. Case Rep Pediatr. 2012. doi:10.1155/2012/491692Google Scholar
  54. 54.
    Daugherty LE. Extracorporeal membrane oxygenation as rescue therapy for methadone-induced pulmonary edema. Pediatr Emerg Care. 2011;27:633–4.PubMedCrossRefGoogle Scholar
  55. 55.
    Escajeda J, Katz K, Rittenberger J. Treatment of metoprolol-induced cardiac arrest with high-dose insulin, lipid emulsion, and VA-ECMO. Crit Care Med. 2013;41 suppl 1:A287.CrossRefGoogle Scholar
  56. 56.
    Bur A, Wagner A, Röggla M, Berzlanovich A, Herkner H, Sterz F, Laggner AN. Fatal pulmonary edema after nitric oxide inhalation. Resuscitation. 1997;35:33–6.PubMedCrossRefGoogle Scholar
  57. 57.
    Kamijo Y, Soma K, Uchimiya H, Asari Y, Ohwada T. A case of serious organophosphate poisoning treated by percutaneous cardiopulmonary support. Vet Hum Toxicol. 1999;41:326–8.PubMedGoogle Scholar
  58. 58.
    Bertram A, Haenel SS, Hadem J, Hoeper MM, Gottlieb J, Warnecke G, Kaschinski S, Hafer C, Kühn-Velten WN, Günther D, Kielstein JT. Tissue concentration of paraquat on day 32 after intoxication and failed bridge to transplantation by extracorporeal membrane oxygenation therapy. BMC Pharmacol Toxicol. 2013;14:45.PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    Tang X, Sun B, He H, Li H, Hu B, Qiu Z, Li J, Zhang C, Hou S, Tong Z, Dai H. Successful extracorporeal membrane oxygenation therapy as a bridge to sequential bilateral lung transplantation for a patient after severe paraquat poisoning. Clin Toxicol. 2015;53:908–13.CrossRefGoogle Scholar
  60. 60.
    Toronto Lung Transplant Group. Sequential bilateral lung transplantation for paraquat poisoning: a case report. J Thorac Cardiovasc Surg. 1985;89:734–42.Google Scholar
  61. 61.
    Lemoine TJ, Schoolman K, Jackman G, Vernon DD. Unintentional fatal phosphine gas poisoning of a family. Pediatr Emerg Care. 2011;27:869–71.PubMedCrossRefGoogle Scholar
  62. 62.
    Pasic M, Potapov E, Kuppe H, Hetzer R. Prolonged cardiopulmonary bypass for severe drug intoxication. J Thorac Cardiovasc Surg. 2000;119:379–80.PubMedCrossRefGoogle Scholar
  63. 63.
    De Rita F, Barozzi L, Franchi G, Faggian G, Mazzucco A, Luciani GB. Rescue extracorporeal life support for acute verapamil and propranolol toxicity in a neonate. Artif Organs. 2011;35:416–20.PubMedCrossRefGoogle Scholar
  64. 64.
    McVey FK, Corke CF. Extracorporeal circulation in the management of massive propranolol overdose. Anaesthesia. 1991;46:744–6.PubMedCrossRefGoogle Scholar
  65. 65.
    Lannemyr L, Knudsen K. Severe overdose of quetiapine treated successfully with extracorporeal life support. Clin Toxicol. 2012;50:258–61.CrossRefGoogle Scholar
  66. 66.
    Tecklenburg FW, Thomas NJ, Webb SA, Case C, Habib DM. Pediatric ECMO for severe quinidine cardiotoxicity. Pediatr Emerg Care. 1997;13:111–3.PubMedCrossRefGoogle Scholar
  67. 67.
    Machiels JP, Evrard P, Dive A, Bulpa P, Installé E. Venovenous ECMO in life-threatening radiocontrast-mediated ARDS. Intensive Care Med. 1999;25:546–50.PubMedCrossRefGoogle Scholar
  68. 68.
    Panzeri C, Bacis G, Ferri F, Rinaldi G, Persico A, Uberti F, Restani P. Extracorporeal life support in a severe Taxus baccata poisoning. Clin Toxicol. 2010;48:463–5.CrossRefGoogle Scholar
  69. 69.
    Soumange N, Chauvet S, Chatellier D, Robert R, Charrière JM, Menu P. Treatment of yew leaf intoxication with extracorporeal circulation. Am J Emerg Med. 2011;29:354.e5–6.Google Scholar
  70. 70.
    Thooft A, Goubella A, Fagnoul D, Taccone FS, Brimioulle S, Vincent JL, De Backer D. Combination of veno-arterial extracorporeal membrane oxygenation and hypothermia for out-of-hospital cardiac arrest due to Taxus intoxication. Can J Emerg Med. 2013;15:1–4.Google Scholar
  71. 71.
    Daubin C, Quentin C, Goullé JP, Guillotin D, Lehoux P, Lepage O, Charbonneau P. Refractory shock related to tramadol overdose. Clin Toxicol. 2007;45:961–4.CrossRefGoogle Scholar
  72. 72.
    Elkalioubie A, Allorge D, Robriquet L, Wiart JF, Garat A, Broly F, Fourrier F. Near-fatal tramadol cardiotoxicity in a CYP2D6 ultrarapid metabolizer. Eur J Clin Pharmacol. 2011;67:855–8.PubMedCrossRefGoogle Scholar
  73. 73.
    Aaronson PM, Wassil SK, Kunisaki TA. Hyperinsulinemic euglycemia, continuous veno-veno hemofiltration, and extracorporeal life support for severe verapamil poisoning: case report. Clin Toxicol. 2009;47:742.Google Scholar
  74. 74.
    Hendren WG, Schieber RS, Garrettson LK. Extracorporeal bypass for the treatment of verapamil poisoning. Ann Emerg Med. 1989;18:984–7.PubMedCrossRefGoogle Scholar
  75. 75.
    Holzer M, Sterz F, Schoerkhuber W, Behringer W, Domanovits H, Weinmar D, Weinstabl C, Stimpfl T. Successful resuscitation of a verapamil-intoxicated patient with percutaneous cardiopulmonary bypass. Crit Care Med. 1999;27:2818–23.PubMedCrossRefGoogle Scholar
  76. 76.
    Martin C, Gonzalez H, Ruiz S, Ribes D, Franchitto N, Minville V. Acute respiratory distress following verapamil overdose treated with intravenous lipid emulsion: a rare life-threatening complication. Ann Fr Anaesth Réanim. 2014;33:e101–2.CrossRefGoogle Scholar
  77. 77.
    Maclaren G, Butt W, Cameron P, Preovolos A, McEgan R, Marasco S. Treatment of polypharmacy overdose with multimodality extracorporeal life support. Anaesth Intensive Care. 2005;33:120–3.PubMedGoogle Scholar
  78. 78.
    Rygnestad T, Moen S, Wahba A, Lien S, Ingul CB, Schrader H, Knapstad SE. Severe poisoning with sotalol and verapamil. Recovery after 4 h of normothermic CPR followed by extra corporeal heart lung assist. Acta Anaesthesiol Scand. 2005;49:1378–80.PubMedCrossRefGoogle Scholar
  79. 79.
    Chian CF, Wu CP, Chen CW, Su WL, Yeh CB, Perng WC. Acute respiratory distress syndrome after zinc chloride inhalation: survival after extracorporeal life support and corticosteroid treatment. Am J Crit Care. 2010;19:86–90.PubMedCrossRefGoogle Scholar
  80. 80.
    Massetti M, Bruno P, Babatasi G, Neri E, Khayat A. Cardiopulmonary bypass and severe drug intoxication. J Thorac Cardiovasc Surg. 2000;120:424.PubMedCrossRefGoogle Scholar
  81. 81.
    Massetti M, Tasle M, Le Page O, Deredec R, Babatasi G, Buklas D, Thuaudet S, Charbonneau P, Hamon M, Grollier G, Gerard JL, Khayat A. Back from irreversibility: extracorporeal life support for prolonged cardiac arrest. Ann Thorac Surg. 2005;79:178–84.PubMedCrossRefGoogle Scholar
  82. 82.
    Mégarbane B, Leprince P, Deye N, Résière D, Guerrier G, Rettab S, Theodore J, Karyo S, Gandjbakhch I, Baud FJ. Emergency feasibility in medical intensive care unit of extracorporeal life support for refractory cardiac arrest. Intensive Care Med. 2007;33:758–64.PubMedCrossRefGoogle Scholar
  83. 83.
    Daubin C, Lehoux P, Ivascau C, Tasle M, Bousta M, Lepage O, Quentin C, Massetti M, Charbonneau P. Extracorporeal life support in severe drug intoxication: A retrospective cohort study of seventeen cases. Crit Care. 2009;13:1–7.CrossRefGoogle Scholar
  84. 84.
    Vanzetto G, Akret C, Bach V, Barone G, Durand M, Chavanon O, Hacini R, Bouvaist H, Machecourt J, Blin D. Assistance circulatoire extracorporelle percutanée dans les défaillances hémodynamique aiguës graves: Expérience monocentrique chez 100 patients consécutifs. Can J Cardiol. 2009;25:e179–86.PubMedPubMedCentralCrossRefGoogle Scholar
  85. 85.
    Masson R, Colas V, Parienti JJ, Lehoux P, Masetti M, Charbonneau P, Saulnier F, Daubin C. A comparison of survival with and without extracorporeal life support treatment for severe poisoning due to drug intoxication. Resuscitation. 2012;83:1413–7.PubMedCrossRefGoogle Scholar
  86. 86.
    Mohan B, Gupta V, Ralhan S, Gupta D, Puri S, Wander GS, Singh B. Role of extracorporeal membrane oxygenation in aluminum phosphide poisoning-induced reversible myocardial dysfunction: a novel therapeutic modality. J Emerg Med. 2015;49:651–6.PubMedCrossRefGoogle Scholar
  87. 87.
    Wang GS, Levitan R, Wiegand TJ, Lowry J, Schult RF, Yin S. On behalf of the Toxicology Investigators Consortium. Extracorporeal membrane oxygenation (ECMO) for severe toxicological exposures: review of the Toxicology Investigators Consortium (ToxIC). J Med Toxicol. 2016;12:95–9.PubMedCrossRefGoogle Scholar
  88. 88.
    Brunet J, Valette X, Ivascau C, Lehoux P, Sauneuf B, Dalibert Y, Masson R, Sabatier R, Buklas D, Seguin A, Terzi N, Du Chaeyron D, Parienti JJ, Daubin C. Extracorporeal life support for refractory cardiac arrest or shock: a 10-year study. ASAIO J. 2015;61:676–81.PubMedCrossRefGoogle Scholar
  89. 89.
    Freedman MD, Gal J, Freed CR. Extracorporeal pump assistance – novel treatment for acute lidocaine toxicity. Eur J Clin Pharmacol. 1982;22:129–35.PubMedCrossRefGoogle Scholar
  90. 90.
    Martin TG, Klain MM, Molner RL, Michelson EA, Schneider SM. Extracorporeal life support vs thumper after lethal desipramine OD. Vet Hum Toxicol. 1990;32:349.Google Scholar
  91. 91.
    Larkin GL, Graeber GM, Hollingsed MJ. Experimental amitriptyline poisoning: treatment of severe cardiovascular toxicity with cardiopulmonary bypass. Ann Emerg Med. 1994;23:480–6.PubMedCrossRefGoogle Scholar
  92. 92.
    Bismuth C, Scherrmann JM, Garnier R, Baud FJ, Pontal PG. Elimination of paraquat. Hum Toxicol. 1987;6:63–7.PubMedCrossRefGoogle Scholar
  93. 93.
    Yamashita M, Yamashita M, Ando Y. A long-term follow-up of lung function in survivors of paraquat poisoning. Human Exp Toxicol. 2000;19:99–103.CrossRefGoogle Scholar
  94. 94.
    Dinis-Oliveira RJ, Duarte JA, Sánchez-Navarro A, Remião F, Bastos ML, Carvalho F. Paraquat poisonings: mechanisms of lung toxicity, clinical features, and treatment. Crit Rev Toxicol. 2008;38:13–71.PubMedCrossRefGoogle Scholar
  95. 95.
    Kamholz S. Current perspectives on clinical and experimental single lung transplantation. Chest. 1988;94:390–6.PubMedCrossRefGoogle Scholar
  96. 96.
    Matthew H, Logan A, Woodruff MFA, Heard B. Paraquat poisoning – lung transplantation. Br Med J. 1968;3:759–63.PubMedPubMedCentralCrossRefGoogle Scholar
  97. 97.
    Licker M, Schweizer A, Hohn L, Morel DR, Spiliopoulos A. Single lung transplantation for adult respiratory distress syndrome after paraquat poisoning. Thorax. 1998;53:620–1.PubMedPubMedCentralCrossRefGoogle Scholar
  98. 98.
    Anderson HL, Coran AG, Drongowski RA, Ha HJ, Bartlett RH. Extracellular fluid and total body water changes in neonates undergoing extracorporeal membrane oxygenation. J Pediatr Surg. 1992;27:1003–8.PubMedCrossRefGoogle Scholar
  99. 99.
    Watt KM, Benjamin DK, Cheifetz IM, Moorthy G, Wade KC, Smith PB, Brouwer LKR, Capparelli EV, Cohen-Wolkowiez K. Pharmacokinetics and safety of fluconazole in young infants supported with extracorporeal membrane oxygenation. Pediatr Infect Dis J. 2012;31:1042–7.PubMedPubMedCentralGoogle Scholar
  100. 100.
    Buck ML. Pharmacokinetic changes during extracorporeal membrane oxygenation: implications for drug therapy of neonates. Clin Pharmacokinet. 2003;42:403–17.PubMedCrossRefGoogle Scholar
  101. 101.
    Mehta NM, Halwick DR, Dodson BL, Thompson JE, Arnold JH. Potential drug sequestration during extracorporeal membrane oxygenation: results from an ex vivo experiment. Intensive Care Med. 2007;33:1018–24.PubMedCrossRefGoogle Scholar
  102. 102.
    Mulla H, Lawson G, von Anrep C, Burke MD, Upton DU, Firmin RK, Killer H. In vitro evaluation of sedative drug losses during extracorporeal membrane oxygenation. Perfusion. 2000;15:21–6.PubMedCrossRefGoogle Scholar
  103. 103.
    Dagan O, Klein J, Gruenwald C, Bohn D, Barker G, Koren G. Preliminary studies of the effects of extracorporeal membrane oxygenator on the disposition of common pediatric drugs. Ther Drug Monit. 1993;15:263–6.PubMedCrossRefGoogle Scholar
  104. 104.
    Wildschut ED, Ahsman MJ, Allegaert K, Mothot RAA, Tibboel D. Determinants of drug absorption in different ECMO circuits. Intensive Care Med. 2010;36:2109–16.PubMedPubMedCentralCrossRefGoogle Scholar
  105. 105.
    Bhatt-Mehta V, Annich G. Sedative clearance during extracorporeal membrane oxygenation. Perfusion. 2005;20:309–15.CrossRefGoogle Scholar
  106. 106.
    Shekar K, Roberts JA, Mcdonald CI, Fisquet S, Barnett AG, Mullany DV, Ghassabian S, Wallis SC, Fung YL, Smith MT, Fraser JF. Sequestration of drugs in the circuit may lead to therapeutic failure during extracorporeal membrane oxygenation. Crit Care. 2012;16:R194.PubMedPubMedCentralCrossRefGoogle Scholar
  107. 107.
    Green TP, Isham-Schopf B, Irmiter RJ, Smith C, Uden DL, Steinhorn RH. Inactivation of heparin during extracorporeal circulation in infants. Clin Pharmacol Ther. 1990;48:148–54.PubMedCrossRefGoogle Scholar
  108. 108.
    Buscher H, Vaidiyanathan S, Al-Soufi S, Nguyen DN, Breeding J, Rycus P, Nair P. Sedation practice in veno-venous extracorporeal membrane oxygenation: an international survey. ASAIO J. 2013;59:636–41.PubMedCrossRefGoogle Scholar
  109. 109.
    Schildt B, Ahlgren T, Bergam L, Wendt Y. Adsorption of insulin by infusion materials. Acta Anaesth Scand. 1978;22:556–62.PubMedCrossRefGoogle Scholar
  110. 110.
    D’Arcy PF. Drug interactions with medical plastics. Drug Intell Clin Pharm. 1983;17:726–31.CrossRefGoogle Scholar
  111. 111.
    Turner-Lawrence DE, Kerns W. Intravenous fat emulsion: a potential novel antidote. J Med Toxicol. 2008;4:110–4.CrossRefGoogle Scholar
  112. 112.
    Jamaty C, Bailey B, Laroque A, Notebaert E, Sanago K, Chauny JM. Lipid emulsions in the treatment of acute poisoning: a systematic review of human and animal studies. Clin Toxicol. 2010;48:1–27.CrossRefGoogle Scholar
  113. 113.
    Levine M, Skolnik AB, Ruha AM, Bosak A, Menke N, Pizon A. Complications following antidotal use of intravenous lipid emulsion therapy. J Med Toxicol. 2014;10:10–4.PubMedCrossRefGoogle Scholar
  114. 114.
    Buck ML, Ksenich RA, Wooldridge P. Effect of infusing fat emulsion into extracorporeal membrane oxygenation circuits. Pharmacotherapy. 1997;17:1292–5.PubMedGoogle Scholar
  115. 115.
    Buck ML, Wooldridge P, Ksenich RA. Comparison of methods for intravenous infusion of fat emulsion during extracorporeal membrane oxygenation. Pharmacotherapy. 2005;25:1536–40.PubMedCrossRefGoogle Scholar
  116. 116.
    Lee HMD, Archer JRH, Dargan PI, Wood DM. What are the adverse effects associated with the combined use of intravenous lipid emulsion and extracorporeal membrane oxygenation in the poisoned patient? Clin Toxicol. 2015;53:145–50.CrossRefGoogle Scholar
  117. 117.
    Katz A, Grossestreuer A, Gaieski D, Abella BS, Kumar V, Perrone J. Outcomes of patients resuscitated from cardiac arrest in the setting of drug overdose. Resuscitation. 2015;94:23–7.Google Scholar
  118. 118.
    Modisett KL, Walsh SJ, Heffner AC, Pearson DA, Kerns W. Outcomes in cardiac arrest patients due to toxic exposure treated with therapeutic hypothermia. J Med Toxicol. 2016;12:263–269Google Scholar
  119. 119.
    Wildschut ED, van Saet A, Pokorna P, Ahsman MJ, Nan der Anker JN, Tibboel D. The impact of extracorporeal life support and hypothermia on drug disposition in critically ill infants and children. Pediatr Clin N Am. 2012;59:1183–1204.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Division of Medical ToxicologyDepartment of Emergency Medicine Carolinas Medical CenterCharlotteUSA
  2. 2.Department of Internal Medicine, Department of Emergency MedicineCarolinas Medical CenterCharlotteUSA

Personalised recommendations