Author/Authors :
Hong, Mi Kyoung Department of Critical Care Medicine - Sungkyunkwan University School of Medicine - Seoul, Korea , Yang, Jeong Hoon Department of Critical Care Medicine - Sungkyunkwan University School of Medicine - Seoul, Korea , Chung, Chi-Ryang Department of Critical Care Medicine - Sungkyunkwan University School of Medicine - Seoul, Korea , Park, Jinkyeong Department of Critical Care Medicine - Sungkyunkwan University School of Medicine - Seoul, Korea , Suh, Gee Young Department of Medicine - Sungkyunkwan University School of Medicine - Seoul, Korea , Sung, Kiick Department of Thoracic and Cardiovascular Surgery - Sungkyunkwan University School of Medicine - Seoul, Korea , Cho, Yang Hyun Department of Critical Care Medicine - Sungkyunkwan University School of Medicine - Seoul, Korea
Abstract :
A kind of herbs, aconite is known for cardiac toxicity [1,2]. Hemodynamic support
using extracorporeal life support (ECLS) may be good method if failed conventional
resuscitation. We report two experiences using ECLS in aconite intoxication.
A 47-year-old man, who had taken 20 herbal tablets containing aconite, visited the emergency room because of chest discomfort. An initial electrocardiography (ECG) showed
persistent multifocal ventricular tachycardia (Figure 1). He repeatedly became pulseless
and unconscious. All conventional resuscitation methods including antiarrhythmic medicines, chest compression, and electric cardioversion failed to maintain a stable condition.
After 10 minutes of resuscitation, extracorporeal membrane oxygenation (ECMO) was inserted immediately. A 15-F arterial and 22-F venous catheter were percutaneously inserted
into the right femoral vessels. The initial flow rate was set at 2 L/min. Although ventricular tachyarrhythmia occurred frequently on the first hospital day, soon after, the vital signs
were stabilized. ECG showed a normal sinus rhythm after 33 hours of ECLS. The ECLS
was removed on hospital day 2. He was discharged on hospital day 10.
