Successful extracorporeal cardiopulmonary resuscitation in a refractory out-of-hospital cardiac arrest after ethylene glycol poisoning

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00843989%3A_____%2F24%3AE0111310" target="_blank" >RIV/00843989:_____/24:E0111310 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/61988987:17110/24:A2503AC0

Výsledek na webu

<a href="https://www.signavitae.com/articles/10.22514/sv.2024.164" target="_blank" >https://www.signavitae.com/articles/10.22514/sv.2024.164</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.22514/sv.2024.164" target="_blank" >10.22514/sv.2024.164</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Successful extracorporeal cardiopulmonary resuscitation in a refractory out-of-hospital cardiac arrest after ethylene glycol poisoning

Popis výsledku v původním jazyce

Here, we report the first case of successful extracorporeal cardiopulmonary resuscitation (eCPR) in a patient with an out-of-hospital cardiac arrest following the ingestion of a lethal dose of ethylene glycol (EG). A 49-year-old man was found unconscious for an unknown period of time after suspected ethylene glycol ingestion. Upon arrival of the Emergency Medical Service (EMS), the patient was found to have a Glasgow Coma Score of 3, bilateral non-reactive mydriasis, and hypoventilation. Despite the urgent orotracheal intubation, the patient developed cardiac arrest immediately thereafter. After 8 minutes of conventional CPR, the regional ECMO (extracorporeal membrane oxygenation) center was contacted. The patient was transferred under mechanical CPR to an ECMO center where veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was initiated 59 minutes after the cardiac arrest. Laboratory tests confirmed EG intoxication with a plasmatic EG level of 1474 mg/L, greatly exceeding reported lethal values. A left stellate ganglion blockade was performed because of refractory ventricular fibrillation, and the return of spontaneous circulation was achieved 149 minutes after the cardiac arrest. As a result of direct organ toxicity, the patient developed anuric acute kidney injury and multifocal brain lesions revealed by nuclear magnetic resonance imaging. In addition to the VA-ECMO, the therapeutic protocol included hemodialysis, intravenous ethanol and fomepizole. This multimodal treatment eventually led to the patient’s survival with near complete recovery.

Název v anglickém jazyce

Successful extracorporeal cardiopulmonary resuscitation in a refractory out-of-hospital cardiac arrest after ethylene glycol poisoning

Popis výsledku anglicky

Here, we report the first case of successful extracorporeal cardiopulmonary resuscitation (eCPR) in a patient with an out-of-hospital cardiac arrest following the ingestion of a lethal dose of ethylene glycol (EG). A 49-year-old man was found unconscious for an unknown period of time after suspected ethylene glycol ingestion. Upon arrival of the Emergency Medical Service (EMS), the patient was found to have a Glasgow Coma Score of 3, bilateral non-reactive mydriasis, and hypoventilation. Despite the urgent orotracheal intubation, the patient developed cardiac arrest immediately thereafter. After 8 minutes of conventional CPR, the regional ECMO (extracorporeal membrane oxygenation) center was contacted. The patient was transferred under mechanical CPR to an ECMO center where veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was initiated 59 minutes after the cardiac arrest. Laboratory tests confirmed EG intoxication with a plasmatic EG level of 1474 mg/L, greatly exceeding reported lethal values. A left stellate ganglion blockade was performed because of refractory ventricular fibrillation, and the return of spontaneous circulation was achieved 149 minutes after the cardiac arrest. As a result of direct organ toxicity, the patient developed anuric acute kidney injury and multifocal brain lesions revealed by nuclear magnetic resonance imaging. In addition to the VA-ECMO, the therapeutic protocol included hemodialysis, intravenous ethanol and fomepizole. This multimodal treatment eventually led to the patient’s survival with near complete recovery.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30221 - Critical care medicine and Emergency medicine

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Signa Vitae

ISSN

1334-5605

e-ISSN

1845-206X

Svazek periodika

20

Číslo periodika v rámci svazku

12

Stát vydavatele periodika

SG - Singapurská republika

Počet stran výsledku

5

Strana od-do

131-135

Kód UT WoS článku

001376976400013

EID výsledku v databázi Scopus

2-s2.0-85212041638