Jornal de Toxicologia Clínica
Acesso livre

Abstrato

Multiple Organ Dysfunction Syndrome Complicating Refractory Cardiogenic Shock Caused by Methadone Overdose and Treated by Extracorporeal Life Support (ECLS)

Antoine Beurton, Julien Imbault, Ruben Concalves, Benjamin Repusseau, Alexandre Ouattara, CHU Bordeaux

We describe a patient presenting multiple organ dysfunction syndromes complicating a refractory cardiogenic shock caused by massive methadone intoxication. Neither ECG changes nor echocardiography abnormalities suggesting the diagnosis of Takotsubo syndrome could be observed at the admission. The QT interval was also normal. An Extracorporeal Life Support (ECLS) was rapidly implanted in bridge to decision. The myocardial failure was fully reversible after 10 days. This case is the first to report multiple organ dysfunction syndromes complicating refractory cardiogenic shock related to methadone poisoning requiring ECLS. It emphasizes that a diagnosis must be imperatively suspected in patients with history of drug abuse and for whom methadone is rendered available even in absence of typical ECG and/or echocardiography changes.