Department of Cardiovascular Surgery, Medical Center-University of Freiburg, Freiburg, Baden-Württemberg, Germany.
University of Freiburg Faculty of Medicine, Freiburg, Baden-Württemberg, Germany.
Thorac Cardiovasc Surg. 2024 Jun;72(4):288-295. doi: 10.1055/s-0043-1764160. Epub 2023 Mar 20.
Extracorporeal membrane oxygenation (ECMO) has been increasingly applied over recent decades to treat severe cardiogenic shock and acute lung failure and cardiac arrest of various causes. Acute intoxication with therapeutic substances or other chemical substances can cause severe cardiogenic shock or even cardiac arrest. The purpose of this study was to conduct a qualitative systematic review of ECMO use in intoxication and poisoning. We searched the PubMed, Medline, and Web of Science databases from January 1971 to December 2021 and selected appropriate studies according to our inclusion and exclusion criteria to evaluate the role of ECMO in intoxication and poisoning systematically. Survival at hospital discharge was examined to describe the outcome. The search resulted in 365 publications after removing duplicates. In total, 190 full-text articles were assessed for eligibility. A total of 145 articles from 1985 to 2021 were examined in our final qualitative analysis. A total of 539 (100%) patients were included (mean age: 30.9 ± 16.6 years), with a distribution of = 64 (11.9%) cases with venovenous (vv) ECMO, = 218 (40.4%) cases with venoarterial (va) ECMO, and = 257 (47.7%) cases with cardiac arrest and extracorporeal cardiopulmonary resuscitation. Survival at hospital discharge was 61.0% for all patients, 68.8% for vaECMO, 75% for vvECMO, and 50.9% for extracorporeal cardiopulmonary resuscitation. When used and reported, ECMO seems to be a valid tool for adult and pediatric patients suffering intoxication from various pharmaceutical and nonpharmaceutical substances due to a high survival rate at hospital discharge.
体外膜肺氧合（ECMO）在最近几十年中越来越多地用于治疗严重的心源性休克、急性呼吸衰竭和各种原因引起的心脏骤停。治疗性物质或其他化学物质的急性中毒可导致严重的心源性休克甚至心脏骤停。本研究旨在对 ECMO 在中毒和中毒中的应用进行定性系统评价。我们检索了 1971 年 1 月至 2021 年 12 月的 PubMed、Medline 和 Web of Science 数据库，并根据纳入和排除标准选择了合适的研究，以系统评估 ECMO 在中毒和中毒中的作用。观察了出院时的生存率，以描述结局。检索后去除重复项得到 365 篇文献。共有 190 篇全文文章符合纳入标准。我们最终的定性分析共检查了 1985 年至 2021 年的 145 篇文章。共纳入 539 例（100%）患者（平均年龄：30.9±16.6 岁），其中 64 例（11.9%）为静脉-静脉 ECMO，218 例（40.4%）为静脉-动脉 ECMO，257 例（47.7%）为心脏骤停和体外心肺复苏。所有患者出院时的生存率为 61.0%，vaECMO 为 68.8%，vvECMO 为 75.0%，体外心肺复苏为 50.9%。当使用和报告 ECMO 时，由于出院时的生存率较高，它似乎是一种有效的工具，适用于因各种药物和非药物物质中毒而接受治疗的成人和儿科患者。
