Extracorporeal membrane oxygenation rescues thyrotoxicosis-related circulatory collapse
Journal
Thyroid : official journal of the American Thyroid Association
Journal Volume
21
Journal Issue
4
Pages
439
Date Issued
2011-04
Author(s)
Abstract
Background: Heart failure is one of the best-known complications of thyrotoxicosis. Thyrotoxicosis-induced heart failure sometimes causes circulatory collapse with a high mortality. There is little published information regarding venous-artery mode extracorporeal membrane oxygenation (V-A mode ECMO) to treat circulatory collapse in patients with thyrotoxicosis. Here, we present four patients who received this treatment.
Summary: We present four patients of severe heart failure secondary to severe thyrotoxicosis. All patients suffered from cardiovascular collapse initially. In addition to primary resuscitation and the antithyroid drugs provided, ECMO was applied for temporally hemodynamic support. One patient expired, and the other three patients successfully recovered from heart failure under the support of V-A mode ECMO. The thyroid function also returned to normal range.
Conclusion: Patients experiencing heart failure due to severe thyrotoxicosis should be admitted to intensive care unit for close hemodynamic monitor. In addition, mechanical circulatory support such as ECMO should be provided immediately once circulatory collapse occurs.
SDGs
Other Subjects
beta adrenergic receptor blocking agent; digoxin; diuretic agent; dopamine; hydrocortisone; inotropic agent; lactic acid; liothyronine; noradrenalin; propylthiouracil; thyrotropin; thyroxine; verapamil; acute coronary syndrome; adult; angiocardiography; article; assisted circulation; asystole; balloon dilatation; blood pH; body temperature; cardiogenic shock; cardioversion; case report; chest tightness; collapse; congestive heart failure; coronary artery; corticosteroid therapy; drug megadose; dyspnea; echocardiography; electrocardiography; extracorporeal oxygenation; female; free thyroxine index; Graves disease; heart atrium fibrillation; heart dilatation; heart failure; heart hemodynamics; heart left ventricle contractility; heart left ventricle ejection fraction; heart left ventricle failure; heart palpitation; heart rate; hormonal therapy; human; hyperthermia; hyperthyroidism; hypoglycemia; hypokinesia; intensive care unit; intraarterial balloon pump; lactate blood level; liothyronine blood level; low drug dose; lung edema; male; mean arterial pressure; metabolic acidosis; mitral valve regurgitation; patient compliance; priority journal; respiratory tract intubation; resuscitation; thorax radiography; thyroid function; thyroid function test; thyrotoxicosis; thyrotropin blood level; thyroxine blood level; vascular patency; Adult; Extracorporeal Membrane Oxygenation; Fatal Outcome; Female; Heart Failure; Humans; Male; Middle Aged; Shock; Thyrotoxicosis; Treatment Outcome
Publisher
MARY ANN LIEBERT, INC
Type
journal article