A patient with a severe drug overdose may benefit from extracorporeal life support (ECLS).
NOTE: Extracorporeal life support is different from extracorporeal toxin removal, which is used to remove the toxin from the patient. Both techniques can be used in the same patient.
Patient selection: severe drug intoxication, usually including one or more cardiotoxic drugs
Site requirement: health care team experienced in ECLS management
Indications for ECLS:
(1) refractory shock: shock not responding to optimal conventional treatment
(2) refractory cardiac arrest: absence of spontaneous circulation after continuous cardiopulmonary resuscitation for >= 45 minutes
Criteria for successful ECLS:
(1) flow rate > 2.5 L per minute (Duabin et al says "> 2.5 L per meter square" but all other references are to L/min).
(2) mean blood pressure > 60 mm Hg
Premature discontinuation for ECLS:
(1) overwhelming sepsis
(2) multiorgan failure
(3) severe neurological complications
(4) massive hemorrhage
Indications for weaning of ECLS after successful life support: Cardiovascular status stable with a left ventricular ejection fraction > 50% at reduced ECLS pump support
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Specialty: Critical Care, Emergency Medicine