Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 1;67(11):e186-e190.
doi: 10.1097/MAT.0000000000001362.

Use of Hemoadsorption in Patients With Severe Intoxication Requiring Extracorporeal Cardiopulmonary Support-A Case Series

Daniel Zickler  1 , Jens Nee, Tim Arnold, Tim Schröder, Torsten Slowinski, Kai-Uwe Eckardt, Roland Körner, Jan Matthias Kruse
Affiliations

Use of Hemoadsorption in Patients With Severe Intoxication Requiring Extracorporeal Cardiopulmonary Support-A Case Series

Daniel Zickler et al. ASAIO J. .

Abstract

Drugs intoxications often lead to severe vasoplegia and cardiogenic shock, and VA-ECMO represents a viable therapy option. However, as cardiopulmonary support is not contributing to the removal of the causal agent from the blood, detoxification by a new hemoadsorption device (CytoSorb) could represent a potential therapeutic tool due to its highly efficient elimination capacity of endogenous but also exogenous hydrophobic substances for which otherwise no effective antidote exist. In this case series, four anecdotal cases of acute intoxications requiring VA-ECMO support used as extracorporeal cardiopulmonary resuscitation after intoxication-induced out-of-hospital cardiac arrest (OHCA) are presented, who were additionally treated with CytoSorb hemoadsorption in combination with renal replacement therapy. Combined treatment was associated with a considerable decrease in plasma levels of the overdosed drugs. Additionally, the combination of applied techniques was safe, practical, and technically feasible with no adverse or any device-related side effects documented during or after the treatment sessions. Based on the reported dramatic decline in drug levels during treatment, that fits in the device's characteristics, we strongly suggest to further investigate the potentially lifesaving role of CytoSorb therapy in patients with acute intoxications requiring multiple organ support techniques.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors have no conflicts of interest to report.

References

    1. Park JH, Shin SD, Song KJ, Park CB, Ro YS, Kwak YH: Epidemiology and outcomes of poisoning-induced out-of-hospital cardiac arrest. Resuscitation. 83: 51–57, 2012.
    1. Vignesh C, Kumar M, Venkataraman R, Rajagopal S, Ramakrishnan N, Abraham BK: Extracorporeal membrane oxygenation in drug overdose: A clinical case series. Indian J Crit Care Med. 22: 111–115, 2018.
    1. Mowry JB, Spyker DA, Cantilena LR, et al.: 2013 Annual report of the American association of poison control centers’ national poison data system (NPDS): 31st annual report. Clin Toxicol (Phila). 52:1032–1283, 2014.
    1. 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. 47: 527–531, 2014.
    1. Jansen T, Petersen H, Malskaer CM, et al.: Activated charcoal haemoperfusion in the treatment of experimental amitriptyline poisoning in pigs—the effect on amitriptyline plasma concentration and haemodynamic parameters. Basic Clin Pharmacol Toxicol. 120:491–497, 2017.

MeSH terms