• Pediatric emergency care · Jan 2011

    Case Reports

    Refractory hypotension from massive bupropion overdose successfully treated with extracorporeal membrane oxygenation.

    • Asha N Shenoi, Shira J Gertz, Sushmita Mikkilineni, and Meena Kalyanaraman.
    • Department of Pediatrics, Children's Hospital of New Jersey, Newark, NJ 07112, USA.
    • Pediatr Emerg Care. 2011 Jan 1; 27 (1): 43-5.

    AbstractAn 11-month-old male infant presented with history of bupropion ingestion (750 mg/kg). He developed seizures, respiratory failure, and severe hypotension with metabolic acidosis refractory to inotropic support. The patient received mechanical ventilation, intralipids, phenytoin, inotropic support (dopamine, norepinephrine, and epinephrine), and extracorporeal membrane oxygenation (ECMO). Inotropes were weaned upon initiation of ECMO and discontinued 66 hours after ingestion. Total ECMO duration was 71 hours. The patient was extubated on hospital day 8 and has not had any neurological sequelae upon 12-month follow-up examinations. We report for the first time successful use of ECMO after ingestion of a potentially fatal dose of bupropion.

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