Extracorporeal Membrane Oxygenation for Acute Toxic Inhalations: Case Reports and Literature Review

Dun Yu; Zhang Xiaolin; Pan Lei; Li Feng; Zhang Lin; Shen Jie

doi:10.3389/fmed.2021.745555

Extracorporeal Membrane Oxygenation for Acute Toxic Inhalations: Case Reports and Literature Review

Front Med (Lausanne). 2021 Sep 29:8:745555. doi: 10.3389/fmed.2021.745555. eCollection 2021.

Authors

Dun Yu¹, Zhang Xiaolin², Pan Lei², Li Feng², Zhang Lin^{1

3}, Shen Jie^{1

3}

Affiliations

¹ Department of Emergency and Critical Care Medicine, Jinshan Hospital, Fudan University, Shanghai, China.
² Department of Respirology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
³ Department of Critical Care Medicine, Medical Research Center of Chemical Injury, Jinshan Hospital, Fudan University, Shanghai, China.

Abstract

Previous studies have shown that poisoning is a major threat to human health. Inhalation of acute toxic gas has been linked to serious health consequences. Among the antidotes for poisoning currently used, supportive care is the most common intervention in clinical practice. Severe acute respiratory distress syndrome (ARDS) and/or refractory cardiogenic shock or cardiac arrest caused by toxins are associated with high mortality and are difficult to treat. Extracorporeal membrane oxygenation (ECMO) is an aggressive supportive measure used to manage severely poisoned patients. This study presents two cases of acute toxic gases inhalation, severe ARDS and circulatory instability induced by bromine inhalation, and ARDS induced by nitric acid inhalation which were successfully treated with ECMO. The ECMO techniques used in the animal models and in human cases to treat severe poisoning are described as well as the indications, contraindications, complications, and weaning of ECMO.

Keywords: ARDS; acute toxic inhalation; cardiac arrest; cardiogenic shock; extracorporeal membrane oxygenation; poisoning.

Publication types

Review