Serial Serum Nicotine Concentration During VA-ECMO for Nicotine-Induced Cardiac Arrest: A Case Report.

IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL

Acute Medicine & Surgery Pub Date : 2026-10-20 eCollection Date: 2026-01-01 DOI:10.1002/ams2.70173

Kensuke Minami, Takeshi Ebihara, Kazuo Harada, Hikaru Tamagawa, Yuto Sugimoto, Shunichiro Nakao, Ryosuke Takegawa, Tomoya Hirose, Hiroshi Matsumoto, Jun Oda

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Abstract

Background: Acute nicotine intoxication can cause cardiac arrest. We report a case of cardiac arrest managed with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) alongside serial serum nicotine monitoring.

Case presentation: A 36-year-old woman collapsed after ingesting an unknown amount of liquid nicotine, up to 20 g. Emergency medical services found her in cardiac arrest with pulseless electrical activity (PEA). On arrival, she remained in cardiac arrest with PEA/asystole and severe acidosis, and VA-ECMO was established 82 min after ingestion. Cardiac function gradually improved, and VA-ECMO was discontinued on Day 3. However, she died on Day 28 from post-cardiac arrest brain injury. Liquid chromatography-mass spectrometry (LC/MS) revealed an admission serum nicotine concentration of 6.44 μg/mL, declining to 0.057 μg/mL within 18 h. This decline paralleled hemodynamic recovery.

Conclusion: Although neurological outcome was unfavorable, VA-ECMO may provide temporary circulatory support during the toxic phase of massive nicotine intoxication.

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VA-ECMO治疗尼古丁引起的心脏骤停期间的连续血清尼古丁浓度：1例报告。

背景：急性尼古丁中毒可引起心脏骤停。我们报告一例心脏骤停与静脉-动脉体外膜氧合（VA-ECMO）和连续血清尼古丁监测。病例介绍：一名36岁妇女在摄入不明数量的液体尼古丁后晕倒，最多20克。紧急医疗服务发现她心脏骤停无脉电活动（PEA）。到达时，患者仍处于心脏骤停，伴有PEA/骤停和严重酸中毒，并在摄入后82分钟建立VA-ECMO。心功能逐渐改善，于第3天停用VA-ECMO。然而，她在第28天死于心脏骤停后的脑损伤。液相色谱-质谱（LC/MS）检测结果显示，入院血清尼古丁浓度为6.44 μg/mL，在18h内降至0.057 μg/mL。这种下降与血流动力学的恢复是平行的。结论：虽然神经系统预后不佳，但VA-ECMO可在大量尼古丁中毒的毒性期提供暂时的循环支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acute Medicine & Surgery MEDICINE, GENERAL & INTERNAL-

自引率

12.50%

发文量

审稿时长

53 weeks