Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
Department of Anesthesiology and Intensive Care Medicine, Rheinische Friedrich-Wilhelms-University, University Hospital Bonn, Bonn, Germany.
Sci Rep. 2024 Sep 18;14(1):21761. doi: 10.1038/s41598-024-72547-0.
Medication poisoning, resulting from the ingestion of cardiotoxic drugs, presents a significant health issue. The mortality rate remains high for patients with myocardial dysfunction refractory to conventional treatments. Venoarterial Extracorporeal Membrane Oxygenation (V-A ECMO) provides temporary support, potentially enhancing patient outcomes. This study aims to assess the efficacy of V-A ECMO in treating cardiovascular failure induced by cardiovascular medication poisoning. We utilized inpatient data from all hospitalisations in Germany from 2007 to 2022 due to cardiovascular medication poisoning treated with V-A ECMO. Patient characteristics, comorbidities, complications and application of ECMO were described descriptively and analysed for statistical significance between survivors and non-survivors. Overall, 49 patients received V-A ECMO for cardiovascular medication poisoning, with a survival rate of 63.6%. The most ingested medications were calcium-channel blockers (38.8%) and beta-adrenoceptor antagonists (34.7%). Half of non-survivors received in-hospital CPR, compared to 12.9% of survivors. Early ECMO implantation (within 24 h of admission) was common (83.7%) but did not significantly impact survival rates. A substantial number of patients presented with multiple substances ingested. V-A ECMO represents a viable option for patients experiencing cardiac failure due to medication poisoning. A structured implementation of V-A ECMO for cardiovascular medication poisoning could lead to higher survival rates.
药物中毒，源于摄入心脏毒性药物，对健康构成重大威胁。对于常规治疗无效的心肌功能障碍患者，死亡率仍然很高。静脉-动脉体外膜肺氧合（V-A ECMO）提供临时支持，可能改善患者预后。本研究旨在评估 V-A ECMO 治疗心血管药物中毒引起的心血管衰竭的疗效。我们利用了 2007 年至 2022 年德国所有因心血管药物中毒接受 V-A ECMO 治疗的住院患者的数据。描述性地描述了患者特征、合并症、并发症和 ECMO 的应用，并对存活者和非存活者进行了统计学意义分析。总体而言，49 名患者因心血管药物中毒接受了 V-A ECMO 治疗，存活率为 63.6%。最常摄入的药物是钙通道阻滞剂（38.8%）和β肾上腺素受体拮抗剂（34.7%）。半数非存活者接受院内心肺复苏（CPR），而存活者为 12.9%。早期 ECMO 植入（入院后 24 小时内）很常见（83.7%），但对生存率没有显著影响。大量患者摄入了多种物质。V-A ECMO 是因药物中毒导致心力衰竭患者的可行选择。为心血管药物中毒实施 V-A ECMO 的结构化方案可能会提高生存率。
