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Use of multimodal mechanical support in refractory cardiogenic shock from bupropion overdose
Cureus
  • Kevin Bodker, Cardiology, Medical University of South Carolina, Charleston, USA.
  • Abdulghani Mounir, Advocate Aurora Health
  • Nathan Marzlin, Advocate Aurora Health
  • Mirza Baig, Advocate Aurora Health
  • Jayant Khitha, Advocate Aurora Health
Affiliations
Aurora Sinai/Aurora St. Luke's Medical Centers
Scholarly Activity Date
9-12-2023
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
Citation Information
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