Cardiogenic Shock in a Hemodialyzed Patient on Flecainide: Treatment with Intravenous Fat Emulsion, Extracorporeal Cardiac Life Support, and CytoSorb® Hemoadsorption

<div>Evolution of serum flecainide concentration over time. IFE: intravenous fat emulsion. The terminal half-life (<span class="nowrap"><svg height="10.7996pt" id="M1" style="vertical-align:-2.98578pt" version="1.1" viewbox="-0.0498162 -7.81382 8.15071 10.7996" width="8.15071pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M324 430H196L233 583L223 592L145 529L120 430H54L29 396L31 388H111L56 126C33 15 54 -12 77 -12C137 -12 214 57 250 95L233 119C208 92 155 59 138 59C126 59 120 70 131 125L186 390L298 394L324 430Z"></path></g><g transform="matrix(.013,0,0,-0.013,4.433,0)"><path d="M138 447C104 447 80 423 80 388C80 355 104 330 137 330C169 330 194 355 194 388C194 423 169 447 138 447ZM138 -228C174 -228 192 -219 192 -198C192 -182 189 -160 185 -119C171 -5 166 111 157 239C152 246 126 246 121 239C112 111 105 -5 92 -119C87 -160 85 -182 85 -198C85 -219 102 -228 138 -228Z"></path></g></svg>)</span> elimination of flecainide was calculated over the first four hours (3.7 hours) following the introduction of CytoSorb® hemoadsorption and over the eighteen following hours (23.4 hours). Note that the terminal half-life was influenced by the combination of CytoSorb®, CVVHDF, and ECLS clearances and of metabolic (hepatic) clearance.</div>

Case Reports in Cardiology

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Figure 1

Figure 1: Cardiogenic Shock in a Hemodialyzed Patient on Flecainide: Treatment with Intravenous Fat Emulsion, Extracorporeal Cardiac Life Support, and CytoSorb® Hemoadsorption 

Figure 1 | Cardiogenic Shock in a Hemodialyzed Patient on Flecainide: Treatment with Intravenous Fat Emulsion, Extracorporeal Cardiac Life Support, and CytoSorb® Hemoadsorption 