Use of multimodal mechanical support in refractory cardiogenic shock from bupropion overdose

Authors

Kevin Bodker, Cardiology, Medical University of South Carolina, Charleston, USA.Follow
Abdulghani Mounir, Advocate Aurora HealthFollow
Nathan Marzlin, Advocate Aurora Health
Mirza Baig, Advocate Aurora HealthFollow
Jayant Khitha, Advocate Aurora HealthFollow

Recommended Citation

Bodker K, Mounir A, Marzlin N, Baig M, Khitha J. Use of Multimodal Mechanical Support in Refractory Cardiogenic Shock From Bupropion Overdose. Cureus. 2023;15(9):e45126. Published 2023 Sep 12. doi:10.7759/cureus.45126

Affiliations

Aurora Sinai/Aurora St. Luke's Medical Centers

Abstract

Massive bupropion overdose has a known association with cardiogenic shock. We describe a clinical case of a 48-year-old female who was brought to the hospital by emergency medical services after ingesting numerous psychiatric medications. Her hospital course was complicated by worsening cardiogenic shock and ventricular tachycardia storm. Transthoracic echocardiography showed left ventricular (LV) hypokinesis with an ejection fraction of 9%. Then the patient underwent placement of a percutaneous Impella CP device (Abiomed, Danvers, MA). The Molecular Adsorbent Recirculating System was started for protein-bound bupropion clearance. After 24 hours, the patient returned to an organized sinus rhythm. A repeat echocardiogram done on the next day demonstrated improved LV function, and the patient had profound clinical improvement. The case illustrates how the use of extracorporeal membrane oxygenation in combination with Impella device and Molecular Adsorbent Recirculating System was able to support the patient's recovery.

Type

Article

PubMed ID

37842414