静脉-动脉体外膜肺氧合在致命性琥珀酸西苯唑啉中毒中的应用价值
Usefulness of venoarterial extracorporeal membranous oxygenation for fatal cibenzoline succinate poisoning.
作者信息
Sato Hiroki, Kyan Ryoko, Uemura Shuji, Toyo Yoshitake, Wada Kenshiro, Nomura Kazuhito, Bunya Naofumi, Narimatsu Eichi
机构信息
Department of Emergency Medicine Sapporo Medical University Sapporo Japan.
Division of Hospital Pharmacy Sapporo Medical University Sapporo Japan.
出版信息
Acute Med Surg. 2020 Apr 16;7(1):e507. doi: 10.1002/ams2.507. eCollection 2020 Jan-Dec.
BACKGROUND
The effect of venoarterial extracorporeal membranous oxygenation (V-A ECMO), plasma exchange (PE), and direct hemoperfusion (DHP) for fatal cibenzoline succinate poisoning is unclear. We report a rare case of severe cibenzoline succinate poisoning along with cardiac arrest, wherein the patient was managed with V-A ECMO, PE, and DHP. We also measured the blood levels of cibenzoline succinate frequently.
CASE PRESENTATION
A 51-year-old woman had a refractory cardiac arrest after cibenzoline succinate ingestion. We initiated V-A ECMO, PE, and DHP. Plasma exchange did not improve clinical manifestations. Her clinical condition improved during DHP, but there was no evidence about removal of drugs. On day 3, DHP and ECMO were terminated. On day 9, she was transferred to another hospital without arrhythmia recurrence.
CONCLUSION
Venoarterial ECMO is effective in cases of cibenzoline succinate poisoning-related cardiac dysfunction or cardiac arrest. No evidence was obtained for the effects of PE and DHP.
背景
静脉-动脉体外膜肺氧合（V-A ECMO）、血浆置换（PE）和直接血液灌流（DHP）用于致命的琥珀酸西苯唑啉中毒的效果尚不清楚。我们报告了一例罕见的严重琥珀酸西苯唑啉中毒合并心脏骤停的病例，该患者接受了V-A ECMO、PE和DHP治疗。我们还频繁测量了琥珀酸西苯唑啉的血药浓度。
病例介绍
一名51岁女性在摄入琥珀酸西苯唑啉后发生难治性心脏骤停。我们启动了V-A ECMO、PE和DHP。血浆置换并未改善临床表现。在直接血液灌流期间她的临床状况有所改善，但没有证据表明药物被清除。第3天，停止了直接血液灌流和体外膜肺氧合。第9天，她被转至另一家医院，未再出现心律失常。
结论
静脉-动脉体外膜肺氧合对琥珀酸西苯唑啉中毒相关的心脏功能障碍或心脏骤停有效。未获得血浆置换和直接血液灌流效果的证据。
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