title: A review of emergency cardiopulmonary bypass for severe poisoning by cardiotoxic drugs.
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.
authors.affiliation: Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. nickjjohnson@gmail.com
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Johnson
authors.forename: David F
authors.initials: DF
authors.lastname: Gaieski
authors.forename: Steven R
authors.initials: SR
authors.lastname: Allen
authors.forename: Jeanmarie
authors.initials: J
authors.lastname: Perrone
authors.forename: Francis
authors.initials: F
authors.lastname: DeRoos
mesh_terms: D000818:Animals; D002315:Cardiopulmonary Bypass / Q000379:methods*; D054715:Cardiotoxins / Q000506:poisoning*; D002319:Cardiovascular System / Q000187:drug effects* / Q000503:physiopathology; D004195:Disease Models, Animal; D062787:Drug Overdose; D004635:Emergency Medicine / Q000379:methods*; D015199:Extracorporeal Membrane Oxygenation; D006355:Heart-Lung Machine; D006801:Humans; D011041:Poisoning / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
chemical_list: D054715:Cardiotoxins