Performance of extracorporeal membrane oxygenation in patients with fatal paraquat poisoning: grasp for straws?

Meng-xiao Feng, Yuan-qiang Lu

Table 1 Clinical characteristics of the five patients in whom extracorporeal membrane oxygenation was performed after fatal paraquat poisoning

Variables Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 Age (years) 15 14 45 25 33 Gender Female Female Male Female Female Ingestion amount (mL) 150 100 110 90 100 Poisoning to admission time (hours) 4 24 24 24 10 Hospital stays (hours) 58.0 79.0 72.5 365.5 298.0 CRRT/HP HP HP HP+CRRT CRRT HP+CRRT Clinical manifestations before ECMO Dyspnea No Yes Yes Yes Yes SaO2 (%) 97.8 60.5 88.1 92.0 70.0 Creatinine (μmol/L) 243 464 354 120 296 PaO2 (mmHg) 112 33 53 60 37 pH 7.40 7.44 7.45 7.45 7.45 WBC (×109/L) 16.6 9.2 33.9 6.7 16.6 APACHE II score 11 28 15 8 12 CT scanning No abnormality Bilateral pulmonary multiple patchy blur Bilateral pulmonary interstitial fibrosis Bilateral pulmonary multiple patchy shadows with partial consolidation; bilateral pleural effusion Bilateral pulmonary diffuse patchy shadows Indications of ECMO Circulatory failure Cardiopulmonary failure Respiratory failure Respiratory failure Respiratory failure ECMO characteristics Poisoning to ECMO time (hours) 21 96 72 144 72 ECMO pattern V-A V-A V-V V-V V-V Bypass LFA-LFV RFA-LFV RFV-RJV RFV-RJV RFV-RJV ECMO complications Hemorrhage at puncture point Hemorrhagic shock Oropharyngeal hemorrhage No Multiple organ hemorrhage ECMO to death time (hours) 41.0 7.0 24.5 245.5 236.0 Death reasons MOF Hemorrhagic shock MOF Respiratory failure, giving up treatment MOF, giving up treatment