Treatment of cardiovascular drug poisoning with Extracorporeal Membrane Oxygenation (ECMO): A review article

This paper aims to review the effect of Extracorporeal Membrane Oxygenation (ECMO) method on treatment of drug poisoning caused by calcium blockers and beta-blockers.  A large proportion of cardiovascular drug poisoning is associated with calcium channel blockers and beta-blockers. Among the various and severe symptoms of poisoning with these drugs, treatment of resistant shock or acute respiratory distress is considered as a challenge. Extracorporeal membrane oxygenation can be used as one of the effective therapies for this type of poisoning. This study is a literature review that was conducted through searching out databases Web of Science, Scopus and PubMed with keywords "Extracorporeal membrane oxygenation", "ECMO", "Calcium channel blocker" and "Beta blocker" in the title, abstract, and keywords of the articles. The articles with focus on the effects of ECMO on treatment of poisoning caused by calcium blocker and beta-blocker drugs were selected and reviewed. Twenty articles were included, in which 23 patients with beta-blocker or calcium blocker poisoning were reported to be treated with ECMO as an adjunct device. VA-ECMO and VV-ECMO were used in 22 and one of cases, respectively. In general, the use of ECMO has been completely successful in more than 90 percent of those patients who suffered from cardiovascular drug poisoning. In view of the newness of ECMO and the lack of clinical trials in this subject, the results of reported case studies indicate a high success rate of this method in treatment of calcium and beta-blockers poisoning. It is recommended this treatment to be considered by healthcare team to treat beta-blocker or calcium blocker poisoning.