A Case of MDMA-Associated Cerebral and Pulmonary Edema Requiring ECMO
Joint Authors
Parekh, K.
El Hachem, K.
Mohanraj, E. M.
Thakkar, Astha
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-11-15
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
A 20-year-old female presented with confusion, generalized tonic-clonic seizures, and severe hyponatremia after ingesting 3,4-methylenedioxymethamphetamine (MDMA).
Brain computed tomography (CT) demonstrated cerebral edema.
Her hospital course was rapidly complicated by respiratory failure and shock requiring intubation and vasopressors.
Refractory acute respiratory distress syndrome (ARDS) was diagnosed which was unresponsive to conventional and salvage therapies, requiring initiation of extracorporeal membrane oxygenation (ECMO), leading to normalization of oxygenation parameters.
Hyponatremia was corrected and the encephalopathy resolved.
The patient was decannulated and extubated after three days.
MDMA-induced hyponatremia is hypothesized to result from enhanced serotonergic activity and arginine vasopressin (AVP) release in the brain leading to hyperthermia-induced polydipsia and syndrome of inappropriate antidiuretic hormone (SIADH) secretion.
A common but often unrecognized complication of severe hyponatremia is the Ayus-Arieff syndrome where cerebral edema causes neurogenic pulmonary edema via centrally mediated increases in catecholamine release and capillary injury.
For our patient, ECMO was required for three days while the hyponatremia was corrected which led to rapid clearing of the cerebral edema and neurogenic pulmonary edema.
This case illustrates that, in selecting patients with refractory ARDS from MDMA-associated cerebral and pulmonary edema, ECMO may be a temporizing and life-saving modality of treatment.
American Psychological Association (APA)
Thakkar, Astha& Parekh, K.& El Hachem, K.& Mohanraj, E. M.. 2017. A Case of MDMA-Associated Cerebral and Pulmonary Edema Requiring ECMO. Case Reports in Critical Care،Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1144406
Modern Language Association (MLA)
Thakkar, Astha…[et al.]. A Case of MDMA-Associated Cerebral and Pulmonary Edema Requiring ECMO. Case Reports in Critical Care No. 2017 (2017), pp.1-4.
https://search.emarefa.net/detail/BIM-1144406
American Medical Association (AMA)
Thakkar, Astha& Parekh, K.& El Hachem, K.& Mohanraj, E. M.. A Case of MDMA-Associated Cerebral and Pulmonary Edema Requiring ECMO. Case Reports in Critical Care. 2017. Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1144406
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1144406