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Extracorporeal membrane oxygenation use is increasing in the US for acute poisoning.
A retrospective study of the National Poison Data System from 2000 to 2018 identified 407 ECMO cases (332 adults – age > 12 years, 75 pediatric – age < 12 years). Increase in ECMO use were more notable in adult population.
Characteristics
- Median age: 27 years (IQR: 15-39)
- Male: 52.6%
- Single substance exposure: 51.5%
- Median number of exposures: 3 (IQR: 2-4)
- Overall survival: 70%
Intentional exposure
- Age > 12 years: 72.6%
- Age < 12 years: 9.3%
Most common class of drug/poison exposure in adults
- Sedative/hypnotic: 26%
- Antidepressants: 25%
- Calcium channel blockers: 19%
- Opioids: 17%
Most common class of drug/poison exposure in children
- Hydrocarbons: 37%
- Antiarrhythmics: 15%
- Antihistamine: 8%
- Unknown: 8%
Most common states that used ECMO for poisoning
- Pennsylvania: 45
- Texas: 27
- Minnesota: 24
- Maryland: 22
- Michigan: 20
- New York: 20
Conclusion
- Increase in EMCO use was most notable in patients with age > 12 years
- There was no significant trend in mortality during the study period
- ECMO cases were mostly reported from urban areas