Successful extracorporeal life support in a case of severe flecainide intoxication.
OBJECTIVE
To show the effectiveness of emergency extracorporeal membrane oxygenation (ECMO) in treating severe, life-threatening flecainide intoxication.


METHODS
Case report.


METHODS
Intensive care unit in a quaternary care center.


METHODS
A patient with electromechanical dissociation after severe flecainide acetate overdose.


METHODS
ECMO.


METHODS
A 30-yr-old male with a history of depression presented after a severe flecainide overdose with plasma concentrations exceeding 20 times the upper boundary of the therapeutic range. At presentation, the patient was in refractory cardiocirculatory collapse and was successfully resuscitated with ECMO. Twenty-six hours later, extracorporeal support could be discontinued and the patient made a full recovery.


CONCLUSIONS
In patients with severe but potentially reversible cardiac dysfunction attributable to flecainide intoxication, ECMO can maintain cardiac output and vital organ perfusion while allowing time for drug redistribution, metabolism, and clearance.
Auzinger
G M
GM
Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Prahran, Melbourne, Australia.
Scheinkestel
C D
CD
D000138:Acidosis / Q000188:drug therapy; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000097:blood / Q000506:poisoning*; D062787:Drug Overdose; D004562:Electrocardiography; D004837:Epinephrine / Q000627:therapeutic use; D015199:Extracorporeal Membrane Oxygenation; D005424:Flecainide / Q000097:blood / Q000506:poisoning*; D006801:Humans; D008297:Male; D012121:Respiration, Artificial; D017693:Sodium Bicarbonate / Q000627:therapeutic use; D013406:Suicide, Attempted; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D017693:Sodium Bicarbonate; D005424:Flecainide; D004837:Epinephrine