Ethylene glycol poisoning requiring veno-arterial ECMO: A case report

• Published in: Perfusion 2024-03, Vol.39 (2), p.423-425
• Main Authors: Orlando, Anita, Sciutti, Fabio, Colombo, Costanza NJ, Fiocco, Ermanno, Ambrosini, Emanuele, Coccolo, Matteo, Pellegrini, Carlo, Degani, Antonella, Biglia, Alessio, Mojoli, Francesco
• Format: Article
• Language: English
• Subjects: Acidosis; Age; Antidotes; Blood; Blood vessels; Case Reports; Computed tomography; Creatinine; Emergency medical care; Emergency medical services; Ethylene glycol; Ethylene Glycols; Extracorporeal Membrane Oxygenation - methods; Hemodynamics; Humans; Intoxication; Lactates; Male; Metabolic acidosis; Shock, Cardiogenic - chemically induced; Shock, Cardiogenic - therapy; Stroke; Veins
• ISSN: 0267-6591; 1477-111X; 1477-111X
• DOI: 10.1177/02676591221141327

Supportive care is the cornerstone of the poisoned patient’s treatment, waiting for eventual antidotes to act. We recently treated a case of a severe Ethylene Glycol intoxication with early-onset veno-arterial ECMO. The patient was taken to our Emergency Department with the suspicion of acute cerebrovascular accident, since he was found unconscious at home. The arterial blood gas and blood tests showed a severe metabolic acidosis with high serum lactates and creatinine levels. The cerebral Computed Tomography was negative. The rapid increase in serum lactates suggested Ethylene Glycol intoxication. Although the patient was not in shock yet, arterial and venous introducers were placed in to the femoral vessels so that when the patient showed the first signs of cardiogenic shock, veno-arterial ECMO could be initiated in a very short time. The hemodynamic state progressively improved and V-A ECMO was removed after 16 h of support with complete recovery.