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