The Recommendation and Use of Extracorporeal Membrane Oxygenation (ECMO) in Cases Reported to the California Poison Control System

Justin Lewis, M. Zarate, S. Tran, Timothy E Albertson

Research output: Contribution to journalArticle

Abstract

Introduction: Antidotes are available to treat some specific poisonings; however, the mainstay of treatment for the poisoned patient remains supportive care. Extracorporeal membrane oxygenation (ECMO) is one of the most aggressive supportive measures available to manage poisoned patients. Objective: To characterize the recommendation and use of ECMO in cases reported to the California Poison Control System (CPCS). Methods: This retrospective chart review queried the CPCS database from 1997 to 2016 for cases containing the American Association of Poison Control Centers (AAPCC) code for ECMO, and “ECMO” and “ECLS” free-text searches. The collected data included year, age, gender, substances involved, route of exposure, clinical effects, treatments, and medical outcome. Results: A total of 94 cases discussed ECMO as a supportive option with 16 cases utilizing ECMO. Cases where ECMO was discussed rose from one case in 1997 to 13 cases in 2016. Of the 94 cases where ECMO was discussed, 38 cases (40%) involved toxicity from a cardiovascular agent(s) and 33 cases (35%) involved exposure to hydrocarbons. Of the 16 cases where ECMO was performed, 13 (81%) involved males. The median age was 17 years (range 1 month–54 years). Ten cases (63%) involve patients under the age of 18. In this series, 13 of 16 ECMO-supported patients survived (81%). Conclusions: ECMO is being recommended more often for treatment of acute poisoning cases by the CPCS. All caregivers involved in the treatment of poisoning should gain a working knowledge of the potentially lifesaving technology of ECMO, its indications for use, adverse effects, and drug or poison interactions.

Original languageEnglish (US)
JournalJournal of Medical Toxicology
DOIs
StatePublished - Jan 1 2019

Fingerprint

Extracorporeal Membrane Oxygenation
Oxygenation
Poisons
Membranes
Control systems
Poison Control Centers
Cardiovascular Agents
Antidotes
Hydrocarbons
Poisoning
Caregivers
Toxicity
Therapeutics

Keywords

  • ECLS
  • ECMO
  • Poison center
  • Poisoning

ASJC Scopus subject areas

  • Toxicology
  • Health, Toxicology and Mutagenesis

Cite this

@article{d283f6ccb1124e86950a10670b9834ea,
title = "The Recommendation and Use of Extracorporeal Membrane Oxygenation (ECMO) in Cases Reported to the California Poison Control System",
abstract = "Introduction: Antidotes are available to treat some specific poisonings; however, the mainstay of treatment for the poisoned patient remains supportive care. Extracorporeal membrane oxygenation (ECMO) is one of the most aggressive supportive measures available to manage poisoned patients. Objective: To characterize the recommendation and use of ECMO in cases reported to the California Poison Control System (CPCS). Methods: This retrospective chart review queried the CPCS database from 1997 to 2016 for cases containing the American Association of Poison Control Centers (AAPCC) code for ECMO, and “ECMO” and “ECLS” free-text searches. The collected data included year, age, gender, substances involved, route of exposure, clinical effects, treatments, and medical outcome. Results: A total of 94 cases discussed ECMO as a supportive option with 16 cases utilizing ECMO. Cases where ECMO was discussed rose from one case in 1997 to 13 cases in 2016. Of the 94 cases where ECMO was discussed, 38 cases (40{\%}) involved toxicity from a cardiovascular agent(s) and 33 cases (35{\%}) involved exposure to hydrocarbons. Of the 16 cases where ECMO was performed, 13 (81{\%}) involved males. The median age was 17 years (range 1 month–54 years). Ten cases (63{\%}) involve patients under the age of 18. In this series, 13 of 16 ECMO-supported patients survived (81{\%}). Conclusions: ECMO is being recommended more often for treatment of acute poisoning cases by the CPCS. All caregivers involved in the treatment of poisoning should gain a working knowledge of the potentially lifesaving technology of ECMO, its indications for use, adverse effects, and drug or poison interactions.",
keywords = "ECLS, ECMO, Poison center, Poisoning",
author = "Justin Lewis and M. Zarate and S. Tran and Albertson, {Timothy E}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s13181-019-00704-3",
language = "English (US)",
journal = "Journal of Medical Toxicology",
issn = "1556-9039",
publisher = "Springer New York",

}

TY - JOUR

T1 - The Recommendation and Use of Extracorporeal Membrane Oxygenation (ECMO) in Cases Reported to the California Poison Control System

AU - Lewis, Justin

AU - Zarate, M.

AU - Tran, S.

AU - Albertson, Timothy E

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: Antidotes are available to treat some specific poisonings; however, the mainstay of treatment for the poisoned patient remains supportive care. Extracorporeal membrane oxygenation (ECMO) is one of the most aggressive supportive measures available to manage poisoned patients. Objective: To characterize the recommendation and use of ECMO in cases reported to the California Poison Control System (CPCS). Methods: This retrospective chart review queried the CPCS database from 1997 to 2016 for cases containing the American Association of Poison Control Centers (AAPCC) code for ECMO, and “ECMO” and “ECLS” free-text searches. The collected data included year, age, gender, substances involved, route of exposure, clinical effects, treatments, and medical outcome. Results: A total of 94 cases discussed ECMO as a supportive option with 16 cases utilizing ECMO. Cases where ECMO was discussed rose from one case in 1997 to 13 cases in 2016. Of the 94 cases where ECMO was discussed, 38 cases (40%) involved toxicity from a cardiovascular agent(s) and 33 cases (35%) involved exposure to hydrocarbons. Of the 16 cases where ECMO was performed, 13 (81%) involved males. The median age was 17 years (range 1 month–54 years). Ten cases (63%) involve patients under the age of 18. In this series, 13 of 16 ECMO-supported patients survived (81%). Conclusions: ECMO is being recommended more often for treatment of acute poisoning cases by the CPCS. All caregivers involved in the treatment of poisoning should gain a working knowledge of the potentially lifesaving technology of ECMO, its indications for use, adverse effects, and drug or poison interactions.

AB - Introduction: Antidotes are available to treat some specific poisonings; however, the mainstay of treatment for the poisoned patient remains supportive care. Extracorporeal membrane oxygenation (ECMO) is one of the most aggressive supportive measures available to manage poisoned patients. Objective: To characterize the recommendation and use of ECMO in cases reported to the California Poison Control System (CPCS). Methods: This retrospective chart review queried the CPCS database from 1997 to 2016 for cases containing the American Association of Poison Control Centers (AAPCC) code for ECMO, and “ECMO” and “ECLS” free-text searches. The collected data included year, age, gender, substances involved, route of exposure, clinical effects, treatments, and medical outcome. Results: A total of 94 cases discussed ECMO as a supportive option with 16 cases utilizing ECMO. Cases where ECMO was discussed rose from one case in 1997 to 13 cases in 2016. Of the 94 cases where ECMO was discussed, 38 cases (40%) involved toxicity from a cardiovascular agent(s) and 33 cases (35%) involved exposure to hydrocarbons. Of the 16 cases where ECMO was performed, 13 (81%) involved males. The median age was 17 years (range 1 month–54 years). Ten cases (63%) involve patients under the age of 18. In this series, 13 of 16 ECMO-supported patients survived (81%). Conclusions: ECMO is being recommended more often for treatment of acute poisoning cases by the CPCS. All caregivers involved in the treatment of poisoning should gain a working knowledge of the potentially lifesaving technology of ECMO, its indications for use, adverse effects, and drug or poison interactions.

KW - ECLS

KW - ECMO

KW - Poison center

KW - Poisoning

UR - http://www.scopus.com/inward/record.url?scp=85063210650&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85063210650&partnerID=8YFLogxK

U2 - 10.1007/s13181-019-00704-3

DO - 10.1007/s13181-019-00704-3

M3 - Article

AN - SCOPUS:85063210650

JO - Journal of Medical Toxicology

JF - Journal of Medical Toxicology

SN - 1556-9039

ER -