Case Report
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Year 2019, Volume: 10 Issue: 4, 124 - 127, 01.10.2019
https://doi.org/10.33706/jemcr.658218

Abstract

References

  • Ehle M, Patel C, Giugliano RP. Digoxin: Clinical highlights. A review of digoxin and its use in contemporary medicine. Crit Pathways in Cardiol, 2011, Vol. 10, pp. 93-98.
  • January CT, Wann LS, Alpert JS et al. 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation. Journal of American College of Cardiology, 2014, Vol. 64 (21), pp. e1-e76.
  • Gheorhgiade M, van Veldhuisen DJ, Colucci WS. Contemporary use of digoxin in the management of cardiac disorders. Circulation, 2006, Vol. 113, pp. 2556-2564.
  • Bauman JL, Didomenico RJ, Galanter WL. Mechanisms, manifestations, and management of digoxin toxicity in the modern era. Am J Cardiovasc Drugs, 2006, Vol. 6, pp. 1-12.
  • Kagawa E. Extracorporeal cardiopulmonary resuscitation for adult cardiac arrest patients. World J Crit Care Med, 2012, Vol. 1 (2), pp. 46-49.
  • Wengenmayer T, Rombach S, Ramshorn F, et al. Influence of low-flow time on survival after extracorporeal cardiopulmonary resuscitation (eCPR). Crit Care. 2017, 21(1):157. doi:10.1186/s13054-017-1744-8,. Published 2017 Jun 22.
  • Farag M, Badowski D, Koschny R, Skopp G, Bricic A, Szabo GB. Extracorporeal life support and digoxin-specific Fab fragments for successful management of Taxus baccata intoxication with low output and ventricular arrhythmia. American Journal of Emergency Medicine, 2017, Vol. 35 (12), pp. 1987.e3-1987.e7.
  • Wu IL, Yu JH, Lin CC, Seak CJ, Olson KR, Chen HY. Fatal cardiac glycoside poisoning due to mistaking foxglove for comfrey. Clin Toxicol (Phila). 2017, 55(7):670–673. doi:10.1080/15563650.2017.1317350.
  • Wermuth ME, Vohra R, Bowman N, Furbee RB, Rusyniak DE. Cardiac Toxicity from Intentional Ingestion of Pong-Pong Seeds (Cerbera Odollam). J Emerg Med. 2018, 55(4):507–511. doi:10.1016/j.jemermed.2018.05.021.
  • Bihari S, Rajajee V. Prolonged retention of awareness during cardiopulmonary resuscitation for asystolic cardiac arrest. Neurocritical Care, 2008, Vol. 9 (3), pp. 382-6.
  • Lewinter JR, Carden DL, Nowak RM, Enriquez E, Martin GB. CPR-dependent consciousness: evidence for cardiac compression causing forward flow. Ann Emerg Med. 1989, 18(10):1111–5.
  • Quinn JV, Hebert PC, Stiell IG. Need for sedation in a patient undergoing active compression–decompression cardiopulmonary resuscitation. Acad Emerg Med. 1994, 1(5):463–6.

Extracorporeal Cardiopulmonary Resuscitation in a Cardiac Arrest Patient Due to Digoxin Overdose Who Was Awake During Conventional Cardiopulmonary Resuscitation

Year 2019, Volume: 10 Issue: 4, 124 - 127, 01.10.2019
https://doi.org/10.33706/jemcr.658218

Abstract

Introduction: Digoxin overdose, which may cause rhythm disturbances, such as atrioventricular blocks, can ultimately cause cardiac arrest. Extracorporeal life support may provide time until specific antidotes show an effect.
Case Report: A 75-year-old male patient presented with dyspnea with a known history of congestive heart failure. His medications included digoxin, and his initial electrocardiography showed an idioventricular rhythm. His digoxin level was over the upper normal limit, and he had hyperkalemia (7.9 Meq/L). The patient collapsed during conventional therapies, including insulin-glucose infusion, atropine administration, and catheterization for emergency hemodialysis, and while awaiting digoxin-specific fragment antibodies. During mechanical cardiopulmonary resuscitation, the patient was awake and had a Full Outline of Unresponsiveness score of 8, which led us to initiate veno-arterial extracorporeal membrane oxygenation.
Conclusion: Extracorporeal Cardiopulmonary Resuscitation, might be a useful option for intoxicated patients when conventional therapies fail. However, more experience is needed for the increase in survival rate.

References

  • Ehle M, Patel C, Giugliano RP. Digoxin: Clinical highlights. A review of digoxin and its use in contemporary medicine. Crit Pathways in Cardiol, 2011, Vol. 10, pp. 93-98.
  • January CT, Wann LS, Alpert JS et al. 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation. Journal of American College of Cardiology, 2014, Vol. 64 (21), pp. e1-e76.
  • Gheorhgiade M, van Veldhuisen DJ, Colucci WS. Contemporary use of digoxin in the management of cardiac disorders. Circulation, 2006, Vol. 113, pp. 2556-2564.
  • Bauman JL, Didomenico RJ, Galanter WL. Mechanisms, manifestations, and management of digoxin toxicity in the modern era. Am J Cardiovasc Drugs, 2006, Vol. 6, pp. 1-12.
  • Kagawa E. Extracorporeal cardiopulmonary resuscitation for adult cardiac arrest patients. World J Crit Care Med, 2012, Vol. 1 (2), pp. 46-49.
  • Wengenmayer T, Rombach S, Ramshorn F, et al. Influence of low-flow time on survival after extracorporeal cardiopulmonary resuscitation (eCPR). Crit Care. 2017, 21(1):157. doi:10.1186/s13054-017-1744-8,. Published 2017 Jun 22.
  • Farag M, Badowski D, Koschny R, Skopp G, Bricic A, Szabo GB. Extracorporeal life support and digoxin-specific Fab fragments for successful management of Taxus baccata intoxication with low output and ventricular arrhythmia. American Journal of Emergency Medicine, 2017, Vol. 35 (12), pp. 1987.e3-1987.e7.
  • Wu IL, Yu JH, Lin CC, Seak CJ, Olson KR, Chen HY. Fatal cardiac glycoside poisoning due to mistaking foxglove for comfrey. Clin Toxicol (Phila). 2017, 55(7):670–673. doi:10.1080/15563650.2017.1317350.
  • Wermuth ME, Vohra R, Bowman N, Furbee RB, Rusyniak DE. Cardiac Toxicity from Intentional Ingestion of Pong-Pong Seeds (Cerbera Odollam). J Emerg Med. 2018, 55(4):507–511. doi:10.1016/j.jemermed.2018.05.021.
  • Bihari S, Rajajee V. Prolonged retention of awareness during cardiopulmonary resuscitation for asystolic cardiac arrest. Neurocritical Care, 2008, Vol. 9 (3), pp. 382-6.
  • Lewinter JR, Carden DL, Nowak RM, Enriquez E, Martin GB. CPR-dependent consciousness: evidence for cardiac compression causing forward flow. Ann Emerg Med. 1989, 18(10):1111–5.
  • Quinn JV, Hebert PC, Stiell IG. Need for sedation in a patient undergoing active compression–decompression cardiopulmonary resuscitation. Acad Emerg Med. 1994, 1(5):463–6.
There are 12 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case Report
Authors

Yunus Emre Özlüer 0000-0001-8297-7525

Mücahit Avcil 0000-0002-2336-8866

Duygu Ege 0000-0001-7530-0065

Çağaç Yetiş 0000-0002-5414-8540

Publication Date October 1, 2019
Submission Date December 12, 2019
Published in Issue Year 2019 Volume: 10 Issue: 4

Cite

APA Özlüer, Y. E., Avcil, M., Ege, D., Yetiş, Ç. (2019). Extracorporeal Cardiopulmonary Resuscitation in a Cardiac Arrest Patient Due to Digoxin Overdose Who Was Awake During Conventional Cardiopulmonary Resuscitation. Journal of Emergency Medicine Case Reports, 10(4), 124-127. https://doi.org/10.33706/jemcr.658218
AMA Özlüer YE, Avcil M, Ege D, Yetiş Ç. Extracorporeal Cardiopulmonary Resuscitation in a Cardiac Arrest Patient Due to Digoxin Overdose Who Was Awake During Conventional Cardiopulmonary Resuscitation. Journal of Emergency Medicine Case Reports. October 2019;10(4):124-127. doi:10.33706/jemcr.658218
Chicago Özlüer, Yunus Emre, Mücahit Avcil, Duygu Ege, and Çağaç Yetiş. “Extracorporeal Cardiopulmonary Resuscitation in a Cardiac Arrest Patient Due to Digoxin Overdose Who Was Awake During Conventional Cardiopulmonary Resuscitation”. Journal of Emergency Medicine Case Reports 10, no. 4 (October 2019): 124-27. https://doi.org/10.33706/jemcr.658218.
EndNote Özlüer YE, Avcil M, Ege D, Yetiş Ç (October 1, 2019) Extracorporeal Cardiopulmonary Resuscitation in a Cardiac Arrest Patient Due to Digoxin Overdose Who Was Awake During Conventional Cardiopulmonary Resuscitation. Journal of Emergency Medicine Case Reports 10 4 124–127.
IEEE Y. E. Özlüer, M. Avcil, D. Ege, and Ç. Yetiş, “Extracorporeal Cardiopulmonary Resuscitation in a Cardiac Arrest Patient Due to Digoxin Overdose Who Was Awake During Conventional Cardiopulmonary Resuscitation”, Journal of Emergency Medicine Case Reports, vol. 10, no. 4, pp. 124–127, 2019, doi: 10.33706/jemcr.658218.
ISNAD Özlüer, Yunus Emre et al. “Extracorporeal Cardiopulmonary Resuscitation in a Cardiac Arrest Patient Due to Digoxin Overdose Who Was Awake During Conventional Cardiopulmonary Resuscitation”. Journal of Emergency Medicine Case Reports 10/4 (October 2019), 124-127. https://doi.org/10.33706/jemcr.658218.
JAMA Özlüer YE, Avcil M, Ege D, Yetiş Ç. Extracorporeal Cardiopulmonary Resuscitation in a Cardiac Arrest Patient Due to Digoxin Overdose Who Was Awake During Conventional Cardiopulmonary Resuscitation. Journal of Emergency Medicine Case Reports. 2019;10:124–127.
MLA Özlüer, Yunus Emre et al. “Extracorporeal Cardiopulmonary Resuscitation in a Cardiac Arrest Patient Due to Digoxin Overdose Who Was Awake During Conventional Cardiopulmonary Resuscitation”. Journal of Emergency Medicine Case Reports, vol. 10, no. 4, 2019, pp. 124-7, doi:10.33706/jemcr.658218.
Vancouver Özlüer YE, Avcil M, Ege D, Yetiş Ç. Extracorporeal Cardiopulmonary Resuscitation in a Cardiac Arrest Patient Due to Digoxin Overdose Who Was Awake During Conventional Cardiopulmonary Resuscitation. Journal of Emergency Medicine Case Reports. 2019;10(4):124-7.