Extracorporeal membrane oxygenation rescues thyrotoxicosis-related circulatory collapse

Heart failure is one of the best-known complications of thyrotoxicosis. Thyrotoxicosis-induced heart failure sometimes causes circulatory collapse with a high mortality. There is little published information regarding venous-artery mode extracorporeal membrane oxygenation (V-A mode ECMO) to treat circulatory collapse in patients with thyrotoxicosis. Here, we present four patients who received this treatment.

We present four patients of severe heart failure secondary to severe thyrotoxicosis. All patients suffered from cardiovascular collapse initially. In addition to primary resuscitation and the antithyroid drugs provided, ECMO was applied for temporally hemodynamic support. One patient expired, and the other three patients successfully recovered from heart failure under the support of V-A mode ECMO. The thyroid function also returned to normal range.

Patients experiencing heart failure due to severe thyrotoxicosis should be admitted to intensive care unit for close hemodynamic monitor. In addition, mechanical circulatory support such as ECMO should be provided immediately once circulatory collapse occurs.