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Predicting factors for the need of extracorporeal membrane oxygenation for suicide attempts by cardiac medication:a single-center cohort study

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World Journal of Emergency Medicine 2022年第4期13卷 283-289页

作者： David Vandroux thomas aujoulat Bernard-Alex Gaüzère Bérénice Puech Bertrand Guihard Olivier Martinet Intensive Care Unit Félix Guyon HospitalUniversity Teaching Hospital of La Réunion97400 Saint DenisReunion IslandFrance Cardiosurgical Intensive Care Unit Dupuytren II HospitalUniversity Teaching Hospital of Limoges87042 LimogesFrance UMR 1094 Neuro-épidémiologie Tropicale University of Limoges87042 LimogesFrance Cardiovascular Anesthesia Department Félix Guyon HospitalUniversity Teaching Hospital of La Réunion97400 Saint DenisReunion IslandFrance Service d’Aide Médicale d’Urgence Félix Guyon HospitalUniversity Teaching Hospital of La Réunion97400 Saint DenisReunion IslandFrance

BACKGROUND:Severe poisoning due to the overdosing of cardiac drugs can lead to cardiovascular *** order to decrease the mortality rate,the most severe patients should be transferred as quickly as possible to an extracorporeal membrane oxygenation(ECMO)***,the predictive factors showing the need for venous-arterial ECMO(VA-ECMO)had never been ***:A retrospective,descriptive,and single-center cohort *** consecutive patients admitted in the largest ICU of Reunion Island(Indian Ocean)between January 2013 and September 2018 for beta-blockers(BB),calcium channel blockers(CCB),renin-angiotensin-aldosterone system blockers,digoxin or anti-arrythmic intentional poisonings were *** implementation was the primary ***:A total of 49 consecutive admissions were *** patients had ECMO,39 patients did not have *** patients in ECMO group died,while no patients in the conventional group *** most relevant ECMO-associated factors were pulse pressure and heart rate at first medical contact and pulse pressure,heart rate,arterial lactate concentration,liver enzymes and left ventricular ejection fraction(LVEF)at *** pulse pressure at first medical contact and LVEF were significant after logistic ***:A transfer to an ECMO center should be considered for a pulse pressure<35 mmHg at first medical contact or LVEF<20%on admission to ICU.

关键词： Extracorporeal membrane oxygenation Implementation Cardiac medication Overdose Predicting factor

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