Extracorporeal life supports

T. H. Shaffer, Partial liquid ventilation in critically ill infants receiving extracorporeal life support. Philadelphia Liquid Ventilation Consortium, Pediatrics 99 (1997) E2. 

Roy, B. J., Rycus, P., Conrad, S. A., and Clark, R. H., The changing demographics of neonatal extracorporeal membrane oxygenation patients reported to the Extracorporeal Life Support Organization (ELSO) Registry, Pediatrics, 2000 106(6) 1334-1338. 

Bartlett, R.H., 2005. Extracorporeal life support history and new directions. Seminars in Perinatology, 2—7. 

Drug overdose Quetiapine overdose is associated with sedation and cardiovascular symptoms such as hypotension, tachycardia and QTc prolongation. A case of a 40-year-old female with profound cardiovas ar depression requiring extracorporeal life support in an ICU is reported [233 ]. In another case, a 42-year-old woman found unconscious experienced cardiovascular collapse and was treated with intravenous lipid emulsion in an ICU [234 ]. 

Lannemyr L, Knudsen K. Severe overdose of quetiapine treated successfully with extracorporeal life support. Clin Toxicol 2012 50(4) 258-61. Bartos M, Knudsen K. Use of intravenous Hpid emulsion in the resuscitation of a patient with cardiovascular collapse after a severe overdose of quetiapine. Clin Toxicol 2013 51(6) 501-4. 

Conrad, S.A., Rycus, P.T., and Dalton, H. 2005. Extracorporeal life support registry report 2004. ASAIO 51(1) 4-10. 

Toomasian, J.M., Schreiner, R.J., and Griffith, G.W. 2005. A polymethylpentene fiber gas exchanger for long-term extracorporeal life support. ASAIO J 51 390-97. 

Serum samples and autopsy specimens were examined from two infants with congenital diaphragmatic hernia who had received life support with extracorporeal membrane oxygenation (ECMO). The serum levels of di(2-ethylhexyl) phthalate after 14 and 24 days of ECMO support were 26.8 and 33.5 mg/L respectively, and levels of 3.5, 1.0 and 0.4 mg/kg di(2-ethylhexyl) phthalate were found in liver, heart and testicular tissues, respectively, and trace quantities were found in the brain. The rate of di(2-ethylhexyl) phthalate extraction from the model PVC circuits was linear with time (rate, 3.5 and 4.1 mg/L per hour). The exposure to di(2-ethylhexyl) phthalate for a 4-kg infant on ECMO support for 3-10 days was estimated to be 42-140 mg/kg (Shneider et al., 1989). 

Basic and advanced life-support measures should be implemented as necessary. In patients presenting within Ih of ingestion, activated charcoal should be administered. In the event of depressed consciousness or seizures, airway protection should first be secured. Sodium bicarbonate, epinephrine, and high-dose diazepam should be used to treat cardiotoxicity. Diazepam is recommended for the treatment of seizures. Methods of extracorporeal drug removal, such as hemoperfusion and hemodialysis, are ineffective. 

Polyacrylamide is used in a wide range of cosmetic products such as moisturizers, lotions, creams, self-tanning products, etc. Polyacrylamides were first used as an implantable carrier for sustained delivery of insulin to lengthen the life of diabetic rats. Since then, various drug delivery systems based on polyacrylamide have been developed. It is also used as a carrier for other bioactive macromolecules and cells to produce the desired effects. Polyacrylamide-chitosan hydrogels are biocompatible and are used for sustained antibiotic release. Polyacrylamide is also used in extra corporeal toxin-removing devices, which remove unwanted toxic substances and subsequently returns the detoxified component to the circulation effectively. The function of polyacrylamide in an extracorporeal toxin removal modality is to provide a support matrix for immobilization of the functional parts or ligands. 

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