Annals of Emergency Medicine
Volume 56, Issue 4 , Pages 409-412 , October 2010

Extracorporeal Life Support in a Case of Fatal Flecainide and Betaxolol Poisoning Allowing Successful Cardiac Allograft

  • Benoît Vivien, MD, PhD

      Affiliations

    • Service d’Aide Médicale Urgente de Paris, Département d'Anesthésie-Réanimation, Hôpital Necker Enfants Malades, Paris, France
    • Corresponding Author InformationAddress for correspondence: Benoît Vivien, MD, PhD, Service d'Aide Médicale Urgente de Paris, Département d'Anesthésie-Réanimation, Hôpital Necker Enfants Malades, 149 Rue de Sèvres, 75743 Paris Cedex 15, France; 33-1-44-49-24-92, fax 33-1-44-49-23-25
    • ,
  • Nicolas Deye, MD

      Affiliations

    • Service de Réanimation Médicale & Toxicologique, Hôpital Lariboisière, Paris, France
    • ,
  • Bruno Mégarbane, MD, PhD

      Affiliations

    • Service de Réanimation Médicale & Toxicologique, Hôpital Lariboisière, Paris, France
    • ,
  • Jean-Sébastien Marx, MD

      Affiliations

    • Service d’Aide Médicale Urgente de Paris, Département d'Anesthésie-Réanimation, Hôpital Necker Enfants Malades, Paris, France
    • ,
  • Pascal Leprince, MD, PhD

      Affiliations

    • Service de Chirurgie Cardiaque, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
    • ,
  • Nicolas Bonnet, MD

      Affiliations

    • Service de Chirurgie Cardiaque, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
    • ,
  • France Roussin, RN

      Affiliations

    • Coordination des Prélèvements d'Organes, Hôpital Saint Louis, Paris, France
    • ,
  • Laurent Jacob, MD

      Affiliations

    • Service de Réanimation Chirurgicale, Hôpital Saint Louis, Paris, France
    • ,
  • Alain Pavie, MD, PhD

      Affiliations

    • Service de Chirurgie Cardiaque, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
    • ,
  • Frédéric J. Baud, MD, PhD

      Affiliations

    • Service de Réanimation Médicale & Toxicologique, Hôpital Lariboisière, Paris, France
    • ,
  • Pierre Carli, MD

      Affiliations

    • Service d’Aide Médicale Urgente de Paris, Département d'Anesthésie-Réanimation, Hôpital Necker Enfants Malades, Paris, France

Received 7 October 2009 ,Revised 4 January 2010 ,Accepted 22 January 2010.

References 

  1. Aubrey P, Arber S, Tyler M. The organ donor crisis: the missed organ donor potential from the accident and emergency departments. Transplant Proc. 2008;40:1008–1011
  2. Hantson P, Mahieu P. Organ donation after fatal poisoning. Q J Med. 1999;92:415–418
  3. Wood DM, Dargan PI, Jones AL. Poisoned patients as potential organ donors: postal survey of transplant centres and intensive care units. Crit Care. 2003;7:147–154
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  5. Tenderich G, Koerner MM, Posival H, et al. Hemodynamic follow-up of cardiac allografts from poisoned donors. Transplantation. 1998;66:1163–1167
  6. Massetti M, Tasle M, Le Page O, et al. Back from irreversibility: extracorporeal life support for prolonged cardiac arrest. Ann Thorac Surg. 2005;79:178–183
  7. Mégarbane B, Leprince P, Deye N, et al. Emergency feasibility in medical intensive care unit of extracorporeal life support for refractory cardiac arrest. Intensive Care Med. 2007;33:758–764
  8. Seger DL. A critical reconsideration of the clinical effects and treatment recommendations for sodium channel blocking drug cardiotoxicity. Toxicol Rev. 2006;25:283–296
  9. Behringer W, Sterz F, Domanovits H, et al. Percutaneous cardiopulmonary bypass for therapy resistant cardiac arrest from digoxin overdose. Resuscitation. 1998;37:47–50
  10. Corkeron MA, van Heerden PV, Newman SM, et al. Extracorporeal circulatory support in near-fatal flecainide overdose. Anaesth Intensive Care. 1999;27:405–408
  11. Auzinger GM, Scheinkestel CD. Successful extracorporeal life support in a case of severe flecainide intoxication. Crit Care Med. 2001;29:887–890
  12. Baud FJ, Mégarbane B, Deye N, et al. Clinical review: aggressive management and extracorporeal support for drug-induced cardiotoxicity. Crit Care. 2007;11:207
  13. Conard GJ, Ober RE. Metabolism of flecainide. Am J Cardiol. 1984;53:41B–51B
  14. Yasui RK, Culclasure TF, Kaufman D, et al. Flecainide overdose: is cardiopulmonary support the treatment?. Ann Emerg Med. 1997;29:680–682
  15. Buck ML. Pharmacokinetic changes during extracorporeal membrane oxygenation: implications for drug therapy of neonates. Clin Pharmacokinet. 2003;42:403–417
  16. Magliocca JF, Magee JC, Rowe SA, et al. Extracorporeal support for organ donation after cardiac death effectively expands the donor pool. J Trauma. 2005;58:1095–1101
  17. Wang CC, Wang SH, Lin CC, et al. Liver transplantation from an uncontrolled non-heart-beating donor maintained on extracorporeal membrane oxygenation. Transplant Proc. 2005;37:4331–4333

 Supervising editor: Richard C. Dart, MD, PhD

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Reprints not available from the authors.

PII: S0196-0644(10)00044-2

doi: 10.1016/j.annemergmed.2010.01.021

Annals of Emergency Medicine
Volume 56, Issue 4 , Pages 409-412 , October 2010

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