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Prolonged Cardiogenic Shock Due to Hydrogen Sulfide Intoxication Requiring Long-Term Venoarterial Extracorporeal
Kristoffer Berg Hansen1,2, Steffen Christensen3, Thomas Birkelund3
1Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
JACC. Case Reports
|November 17, 2022
Summary
Hydrogen sulfide (H2S) gas from manure caused severe heart failure and collapse. Treatment involved extracorporeal membrane oxygenation, successfully supporting the patient for 28 days.
Area of Science:
- Toxicology
- Cardiology
- Biochemistry
Background:
- Hydrogen sulfide (H2S) is a toxic gas commonly found in agricultural environments.
- Exposure to H2S can lead to severe health consequences, including cardiovascular compromise.
Observation:
- A patient presented with acute biventricular failure and cardiovascular collapse after H2S exposure.
- Initial diagnostics revealed myocardial damage and impaired cellular energy production (bioenergetics).
Findings:
- The patient's condition necessitated immediate cardiopulmonary support.
- Venoarterial extracorporeal membrane oxygenation (VA-ECMO) was initiated for hemodynamic and respiratory support.
- Successful weaning from VA-ECMO was achieved after 28 days of intensive management.
Implications:
- This case highlights the critical cardiotoxicity of hydrogen sulfide.
- Effective management strategies, including VA-ECMO, can be life-saving in severe H2S poisoning.
- Further research into H2S-induced myocardial dysfunction and bioenergetic uncoupling is warranted.
Keywords:
ECG, electrocardiogramH2SH2S, hydrogen sulfideHBOT, hyperbaric oxygen therapyLV, left ventricularLVEF, left ventricular ejection fractionPCWP, pulmonary capillary wedge pressurePEA, pulseless electrical activityRV, right ventricularSpo2, peripheral oxygen saturationSvo2, central venous oxygen saturationTAPSE, tricuspid annular plane systolic excursionVA-ECMOVA-ECMO, venoarterial extracorporeal membrane oxygenationbiventricular heart failurecardiogenic shockhydrogen sulfidemanure gasMore Related Videos
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