Bail-out extracorporeal membrane oxygenation for hydroxychloroquine intoxication: a warning for COVID-19 health-care givers.
Wouter HolvoetKaja van SoestThomas HavenithRoberto LorussoWalther N K A van MookThijs DelnoijPublished in: Acta cardiologica (2020)
This case report describes an intentional intoxication with 18 g of hydroxychloroquine (HCQ) presenting with unconsciousness, ventricular dysrhythmias, cardiogenic shock and pulmonary oedema. Initial treatment consisted of sodium bicarbonate, lipid emulsion, diazepam and norepinephrine. Because of persistent cardiogenic shock veno-arterial extracorporeal membrane oxygenation (V-A ECMO) was successfully used as a bridge to recovery. This case underscores the possible side effects of HCQ and the importance of considering ECMO in cardiogenic shock caused by HCQ intoxication which may occur also in patients with coronavirus disease 2019 (COVID-19) based on the currently frequent use of such a compound.
Keyphrases
- extracorporeal membrane oxygenation
- coronavirus disease
- case report
- acute respiratory distress syndrome
- healthcare
- respiratory failure
- sars cov
- respiratory syndrome coronavirus
- pulmonary hypertension
- heart failure
- mechanical ventilation
- left ventricular
- combination therapy
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- catheter ablation
- atrial fibrillation
- affordable care act