J Korean Soc Clin Toxicol.  2016 Jun;14(1):1-8.

Extracorporeal Life Support in Treatment of Poisoning Patient: Systematic Review

Affiliations
  • 1Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea. emstar@yuhs.ac

Abstract

PURPOSE
Extracorporeal life support (ECLS) is a term used to describe a number of modalities including extracorporeal membrane oxygenation (ECMO) to support cardiac and/or pulmonary systems. The purpose of this study is to review the available evidence regarding the effect of ECLS in patients with acute poisoning.
METHODS
Electronic literature searches with PubMed, Embase, Cochrane library, and KoreaMed were conducted for identification of relevant studies addressing ECLS in treatment of acute poisoning. The literature search was conducted by two investigators in March, 2016 with publication language restricted to English and Korean. The toxic substance, technique of ECLS, and final outcome of each case were analyzed.
RESULTS
The final analysis included 64 articles including 55 case reports. There were no articles classified according to a high level of evidence such as randomized trial and prospective cohort study. ECLS treatment was used in the management of patients poisoned with 36 unique substances. Venovenous ECMO was performed in 4 cases. Among the reported cases, 10 patients died despite treatment with ECLS.
CONCLUSION
Evidence supporting ECLS for patients with acute poisoning is inadequate. However, many case reports suggest that early consideration of ECLS in poisoned patients with refractory cardiac arrest or hemodynamic compromise refractory to standard therapies may be beneficial.

Keyword

Cardiopulmonary bypass; Extracorporeal circulation; Extracorporeal membrane oxygenation; Poisoning

MeSH Terms

Cardiopulmonary Bypass
Cohort Studies
Extracorporeal Circulation
Extracorporeal Membrane Oxygenation
Heart Arrest
Hemodynamics
Humans
Poisoning*
Prospective Studies
Publications
Research Personnel
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