Treatment of a patient with aconitine poisoning using veno-arterial membrane oxygenation:A case report  

作　　者：Yu-Yao Bian Jin Hou Sudha Khakurel 

机构地区：[1]Department of Emergency Medicine,Hebei Petro China Central Hospital,Langfang 065000,Hebei Province,China [2]Department of Internal Medicine,Langfang Health Vocational College,Langfang 065000,Hebei Province,China [3]Dallas Campus,UT Health Houston School of Public Health,Dallas,TX 75201,United States

出　　处：《World Journal of Clinical Cases》2024年第21期4842-4852,共11页世界临床病例杂志

摘　　要：BACKGROUND Aconitine poisoning is highly prone to causing malignant arrhythmias.The elimination of aconitine from the body takes a considerable amount of time,and during this period,patients are at a significant risk of death due to malignant arrhythmias associated with aconitine poisoning.CASE SUMMARY A 30-year-old male patient was admitted due to accidental ingestion of aconitinecontaining drugs.Upon arrival at the emergency department,the patient intermittently experienced malignant arrhythmias including ventricular tachycardia,ventricular fibrillation,ventricular premature beats,and cardiac arrest.Emergency interventions such as cardiopulmonary resuscitation and defibrillation were promptly administered.Additionally,veno-arterial extracorporeal membrane oxygenation(VA-ECMO)therapy was initiated.Successful resuscitation was achieved before ECMO placement,but upon initiation of ECMO,the patient experienced recurrent malignant arrhythmias.ECMO was utilized to maintain hemodynamics and respiration,while continuous blood purification therapy for toxin clearance,mechanical ventilation,and hypothermic brain protection therapy were concurrently administered.On the third day of VA-ECMO support,the patient’s respiratory and hemodynamic status stabilized,with only frequent ventricular premature beats observed on electrocardiographic monitoring,and echocardiography indicated recovery of cardiac contractile function.On the fourth day,a significant reduction in toxin levels was observed,along with stable hemodynamic and respiratory functions.Following a successful pump-controlled retrograde trial occlusion test,ECMO assistance was terminated.The patient gradually improved postoperatively and achieved recovery.He was discharged 11 days later.CONCLUSION VA-ECMO can serve as a bridging resuscitation technique for patients with reversible malignant arrhythmias.

关 键 词：POISONING ARRHYTHMIA Blood purification Veno-arterial extracorporeal membrane oxygenation RESUSCITATION Case report 

分 类 号：R285[医药卫生—中药学]