Open AccessUse of Hemoadsorption in Patients With Severe Intoxication Requiring Extracorporeal Cardiopulmonary Support—A Case Series
Author(s) -
Daniel Zickler,
Jens Nee,
Timothy Arnold,
Tim Schröder,
Torsten Slowinski,
KaiUwe Eckardt,
Roland Körner,
Jan Kruse
Publication year - 2021
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.961
H-Index - 66
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0000000000001362
Subject(s) - medicine , extracorporeal , cardiogenic shock , intensive care medicine , renal replacement therapy , extracorporeal cardiopulmonary resuscitation , extracorporeal membrane oxygenation , cardiopulmonary resuscitation , hemoperfusion , hemofiltration , antidote , life support , anesthesia , resuscitation , surgery , hemodialysis , myocardial infarction , toxicity
Drugs intoxications often lead to severe vasoplegia and cardiogenic shock, and VA-ECMO represents a viable therapy option. However, as cardiopulmonary support is not contributing to the removal of the causal agent from the blood, detoxification by a new hemoadsorption device (CytoSorb) could represent a potential therapeutic tool due to its highly efficient elimination capacity of endogenous but also exogenous hydrophobic substances for which otherwise no effective antidote exist. In this case series, four anecdotal cases of acute intoxications requiring VA-ECMO support used as extracorporeal cardiopulmonary resuscitation after intoxication-induced out-of-hospital cardiac arrest (OHCA) are presented, who were additionally treated with CytoSorb hemoadsorption in combination with renal replacement therapy. Combined treatment was associated with a considerable decrease in plasma levels of the overdosed drugs. Additionally, the combination of applied techniques was safe, practical, and technically feasible with no adverse or any device-related side effects documented during or after the treatment sessions. Based on the reported dramatic decline in drug levels during treatment, that fits in the device's characteristics, we strongly suggest to further investigate the potentially lifesaving role of CytoSorb therapy in patients with acute intoxications requiring multiple organ support techniques.