Dexmedetomidine is frequently used for deep sedation during electrophysiology procedures. We report a case where, presumably, the use of dexmedetomidine resulted in a patient's death. The patient developed unexplained and refractory cardiogenic shock and could not be resuscitated. Autopsy failed to demonstrate any abnormality or cause of death. We postulate that, in certain susceptible individuals, dexmedetomidine may lead to terminal complications. We therefore urge caution about using dexmedetomidine in the electrophysiology laboratory.
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http://dx.doi.org/10.1213/ane.0b013e318172fafc | DOI Listing |
Eur Heart J
January 2025
Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen DK-2100, Denmark.
Cardiogenic shock represents a critical condition in which the heart is unable to maintain adequate circulation leading to insufficient tissue perfusion and end-organ failure. Temporary mechanical circulatory support offers the potential to stabilize patients, provide a bridge-to-recovery, provide a bridge-to-decision, or facilitate definitive heart replacement therapies. Although randomized controlled trials have been performed in infarct-related cardiogenic shock and refractory cardiac arrest, the optimal timing, appropriate patient selection, and optimal implementation of these devices remain complex and predominantly based on observational data and expert consensus, especially in non-ischaemic shock.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Duke University Medical Center, Durham, North Carolina.
Background: Direct mechanical ventricular actuation (DMVA) with the Anstadt cup is effective for non-blood-contacting biventricular support. Pneumatic regulation of a silicone device augments ventricular pump function. Vacuum attachment facilitates diastolic augmentation critical for biventricular support.
View Article and Find Full Text PDFZhonghua Wei Zhong Bing Ji Jiu Yi Xue
December 2024
Department of Critical Care Medicine, the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, Guangxi Zhuang Autonomous Region, China. Gao Hanming is working on the Department of Critical Care Medicine, the People's Hospital of Cenxi City, Cenxi 543200, Guangxi Zhuang Autonomous Region, China. Corresponding author: Lu Junyu, Email:
Extracorporeal membrane oxygenation (ECMO), as a critical life support technology, has played a significant role in treating patients with refractory respiratory and circulatory failure. In recent years, with the advancements in medical technology, the scope of application of ECMO has been expanding, especially in the fields of acute respiratory distress syndrome, cardiogenic shock and other important roles. However, its high costs, complex operation, and associated risks of complications remain challenges in clinical practice.
View Article and Find Full Text PDFBMC Pediatr
January 2025
Department of PICU, Children's Medical Center, the First Hospital of Jilin University, 1 Xinmin Street, Changchun, Jilin Province, China.
Background: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited ion channelopathy characterized by a structurally normal heart sensitive to catecholamines. It primarily presents as Bidirectional ventricular tachycardia (BiVT) and is a significant cause of sudden cardiac death in children.
Case Presentation: We report our experience with central Extracorporeal Membrane Oxygenation (ECMO) therapy in a 4-year-old boy with CPVT.
Medicina (Kaunas)
December 2024
Department of Health Science, Anesthesia and ICU, School of Medicine, University of Basilicata San Carlo Hospital, 85100 Potenza, Italy.
Extracorporeal cardiopulmonary resuscitation (ECPR) is a complex, life-saving procedure that uses mechanical support for patients with refractory cardiac arrest, representing the pinnacle of extracorporeal membrane oxygenation (ECMO) applications. Effective ECPR requires precise patient selection, rapid mobilization of a multidisciplinary team, and skilled cannulation techniques. Establishing a program necessitates a cohesive ECMO system that promotes interdisciplinary collaboration, which is essential for managing acute cardiogenic shock and severe pulmonary failure.
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