Hydroxocobalamin and extracorporeal membrane oxygenation (ECMO) for severe refractory shock in bupropion and citalopram overdose: a case report

Introduction Management of refractory shock in the setting overdose can be challenging. We describe a case vasodilatory and cardiogenic after bupropion citalopram overdose. Vasopressors conventional therapies failed to stabilize patient resulting placement venoarterial extracorporeal membrane oxygenation (VA ECMO) for rescue recovery.Case summary: A 23-year-old male presented intentional He developed seizures, acute respiratory failure, metabolic acidosis, severe vasodilatory, shock. The received mechanical ventilation, Advanced Cardiac Life Support (ACLS), Intralipid ® therapy, vasopressor support, VA ECMO. Total duration ECMO was 72 h. Serum laboratory studies drawn on day admission showed serum concentrations (3400 ng/mL, reference range 9-200 ng/mL) (597 50-100 ng/mL). extubated hospital 18 discharged home with referral outpatient psychiatry, 28 days overdose.Conclusions This illustrates successful recovery hydroxocobalamin following citalopram.