Case report: veno-venous ECMO as a bridge to lung transplantation in paraquat poisoning

3 out of 5 stars Successful extracorporeal membrane oxygenation therapy as a bridge to sequential bilateral lung transplantation for a patient after severe paraquat poisoning. Tang X et al.  Clin Toxicol 2015 Aug 28 [Epub ahead of print] Abstract Conceptually, extracorporeal membrane oxygenation (ECMO) seems a perfect technique for treating some of the sickest toxicology patients,  buying time until failing vital functions can recover. With severe cardiotoxins — for example, calcium channel blockers, beta blockers or bupropion — veno-arterial ECMO can provide complete cardiopulmonary bypass, replacing both cardiac and pulmonary function. In the case of severe poisoning with paraquat — a highly toxic herbicide that causes progressive respiratory failure and irreversible pulmonary fibrosis — veno-venous ECMO can replace support pulmonary function and serve as a bridge to lung transplantation. This paper from Beijing Chao-Yang Hospital describes what is, to my knowledge, the first case in which v-v ECMO has been used successfully to treat paraquat poisoning. A 24-year-old, 53-kg woman ingested an estimated 50 ml of 20% paraquat.She arrived at hospital 2 hours later and was initially treated with gastric lavage, laxatives, and activated charcoal. Additional treatment included cyclosphophamide, steroids, and hemoperfusion. Unfortunately, her initial signs and symptoms are not well-described. Three days after presentation, the patie...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical ECMO extracorporeal membrane oxygenation lung transplantation paraquat poisoning Source Type: news

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