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Case report: use of ECMO in colchicine poisoning

Colchicum autumnale (Autumn crocus) 3.5 out of 5 stars Extracorporeal life support in the treatment of colchicine poisoning. Boisramé-Helms J et al. Clin Toxicol 2015;53:827-829. Abstract Colchicine toxicity occurs roughly in 3 phases. During the initial 24 hours, severe gastrointestinal symptoms — nausea, vomiting, and diarrhea — can cause hypotension and shock if fluid losses are not adequately replaced. During the second phase, severe toxicity can manifest with pancytopenia, sepsis, rhabdomyolysis, and renal failure. In addition, within days after ingestion, patients can develop cardiogenic shock and sudden cardiac death. This fascinating case report — from the Nouvel Hôpital Civil in Strasbourg, France — describes the use of veno-arterial extracorporeal membrane oxygenation (ECMO) as a bridge to recover in a patient with colchicine toxicity. A 68-year-old woman inadvertently ingested the Colchicum autumnale plant, thinking it was wild leek. The plant contains colchicine,  especially concentrated in the bulb and seeds. Several hours later she developed severe vomiting and diarrhea. By day 3 (phase 2) she developed shock and multi-organ failure. She was intubated and admitted to the intensive care unit. On or about day 4 (the paper is somewhat vague on the exact time course) V-A ECMO was started because of hypotension resistant to fluids and pressors, along with an ejection fraction of 5-10%. Despite an unsurprisingly...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical autumn crocus colchicine poisoning colchicum autumnale ECLS ECMO extracorporeal life support extracorporeal membrane oxygenation Source Type: news

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