ECMO for Endocrine Emergencies?

lightning storm

How many of you think ECMO for Endocrine Emergencies?  Have a patient with thyroid storm…think ECMO? Diabetic ketoacidosis…think ECMO?? Pheochromocytoma crisis…ECMO???

A recent report from  Chao, A. et al. Highlighting indication of extracorporeal membrane oxygenation in endocrine emergencies. Sci. Rep. 5, 13361; doi: 10.1038/srep13361 (2015).
discusses several cases of endocrine emergencies that have been successfully supported with ECMO.

This report identifies that endocrine emergencies can often present as other diseases such as acute myocardial infarction (AMI) or other causes of refractory shock.  If the cause of the shock can be quickly and accurately determined, then it seems there can be better chance of survival by treating the appropriate underlying disease process.thyroid storm pic

They concluded that “ECMO support can be clinically useful in endocrine emergencies. The screening of endocrine diseases should be considered during the resuscitation of patients with refractory circulatory shock.”

Endocrine diseases may not be at the top of your list for consideration when you have a patient crashing and needing ECMO.  But early recognition and treatment of endocrine emergencies is key to improved outcomes.

So next time you have a severe DKA or thyroid storm patient in cardiopulmonary collapse…maybe ECMO should be considered!