Intra-aortic balloon pump (IABP) rescue therapy for refractory XXXX due to scorpion sting envenomation.

@entity1 @entity1545 @entity296 @entity452 @entity5733 @entity4 @entity1457 @entity1425 @entity12040 @entity591 @entity2224 @entity1167 @entity3159 @entity1063 @entity1455
BACKGROUND: @entity296 , @entity1455 or @entity4 are well recognised complications of scorpion sting envenomation occurring in about 1-3% of @entity1 . Current treatment recommendations include afterload reduction using @entity3159 and improving cardiac contractility with inotropes like @entity452 . We report the use of intra-aortic balloon pump (IABP) as rescue therapy in a @entity1 with refractory @entity1455 due to Mesobuthus tamulus (Indian red scorpion) envenomation. CASE: A 32-year-old @entity1 was referred 24 h after a scorpion sting. At presentation she was ventilated and in @entity1457 (systolic blood pressure   <50   mmHg). After admission, the @entity1 had four cardiac arrests (three episodes of @entity12040 ventricular @entity591 / @entity2224 and one episode of @entity1167 ) over the next few hours. Following resuscitation, despite a combination of @entity452 , @entity1063 , and @entity1425 , blood pressure did not improve significantly. In view of persistent @entity591 (heart rate 160/min), @entity5733 storm was suspected and @entity3159 was added. However, shock was refractory. Hence, IABP was considered as rescue therapy. Following initiation of IABP, there was improvement in cardiac function (improved ejection fraction) which translated to weaning of inotropes over 48 h and improved organ function (renal, respiratory) in the next 2-3 d. However, following extubation, on Day 8, she was noted to have features of @entity1545 . This improved gradually. At discharge (Day 30) she was independent for activities of daily living and was able to mobilise without support. CONCLUSION: IABP could be generally considered as a rescue therapy in refractory @entity1455 in envenomations.
