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VOLUME 26 , ISSUE 4 ( April, 2022 ) > List of Articles


Extracorporeal Membrane Oxygenation Support in Refractory Multi-organ Failure by 3,4-Methylenedioxymethamphetamine Intoxication (“Ecstasy”)

Victoria Ruiz, Foda Rosciani, Indalecio Carboni Bisso, Marcos Las Heras

Keywords : Extracorporeal membrane oxygenation treatment, Intensive care, N-methyl-3,4-methylenedioxyamphetamine

Citation Information : Ruiz V, Rosciani F, Bisso IC, Heras ML. Extracorporeal Membrane Oxygenation Support in Refractory Multi-organ Failure by 3,4-Methylenedioxymethamphetamine Intoxication (“Ecstasy”). Indian J Crit Care Med 2022; 26 (4):523-525.

DOI: 10.5005/jp-journals-10071-24187

License: CC BY-NC 4.0

Published Online: 13-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


The substance known as 3,4-methylenedioxymethamphetamine (MDMA) that is commonly named ecstasy is a designer drug used for recreation. The intoxication for MDMA could generate hyperthermia, hepatotoxicity, acute renal failure, cardiovascular toxicity, hyponatremia, serotonin syndrome, coma, and, eventually could lead to, death. There is no antidote available, that is why the treatment is symptomatic and of advanced vital support until the resolution of the case. A case is presented of an adult with multi-organ failure secondary to intoxication for MDMA in whom it was decided to initiate support of oxygenation with extracorporeal membrane oxygenation as a bridge to recovery, with good results.

  1. Kalant H. The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. CMAJ 2001;165(7):917–928. PMID: 11599334.
  2. Group CEW, Community Epidemiology Work Group. Epidemiologic trends in drug abuse: highlights and executive summary. PsycEXTRA Dataset 2001. DOI: 10.1037/e598902007-001.
  3. Shannon M. Methylenedioxymethamphetamine (MDMA, “Ecstasy”). Pediatr Emerg Care 2000;16(5):377–380. DOI: 10.1097/00006565-200010000-00022.
  4. Wu D, Otton SV, Inaba T, Kalow W, Sellers EM. Interactions of amphetamine analogs with human liver CYP2D6. Biochem Pharmacol 1997;53(11):1605–1612. DOI: 10.1016/s0006-2952(97)00014-2.
  5. Colado MI, Williams JL, Green AR. The hyperthermic and neurotoxic effects of “Ecstasy” (MDMA) and 3,4 methylenedioxyamphetamine (MDA) in the Dark Agouti (DA) rat, a model of the CYP2D6 poor metabolizer phenotype. Br J Pharmacol 1995;115(7):1281–1289. DOI: 10.1111/j.1476-5381.1995.tb15037.x.
  6. Davies N, English W, Grundlingh J. MDMA toxicity: management of acute and life-threatening presentations. Br J Nurs 2018;27(11): 616–622. DOI: 10.12968/bjon.2018.27.11.616.
  7. Wang GS, Levitan R, Wiegand TJ, Lowry J, Schult RF, Yin S, et al. Extracorporeal Membrane Oxygenation (ECMO) for severe toxicological exposures: review of the Toxicology Investigators Consortium (ToxIC). J Med Toxicol 2016;12(1):95–99. DOI: 10.1007/s13181-015-0486-8.
  8. Attia MY, Abdelbary AA, Khaled MM, Abdelfattah AH. Veno-venous extracorporeal membrane oxygenation in a case of organophosphorus poisoning. Egypt J Crit Care Med 2016; 4(1):43–46. DOI: 10.1016/j.ejccm.2016.02.006.
  9. Mehra A, Sharma N. ECMO: A ray of hope for young suicide victims with acute aluminum phosphide poisoning and shock. Indian Heart J 2016;68(3):256–257. DOI: 10.1016/j.ihj.2016.02.006.
  10. Bagate F, Radu C, Mekontso Dessap A, de Prost N. Early extracorporeal membrane oxygenation for cardiovascular failure in a patient with massive chloroquine poisoning. Am J Emerg Med 2017;35(2): 380.e3–380.e4. DOI: 10.1016/j.ajem.2016.08.058.
  11. Sutar A, Venkategowda PM, Murthy A, Chikkaswamy SB. Severe amlodipine toxicity: a case rescued with extracorporeal membrane oxygenation. Indian J Crit Care Med 2020;24(5):365–366. DOI: 10.5005/jp-journals-10071-23423.
  12. Thakkar A, Parekh K, El Hachem K, Mohanraj EM. A case of MDMA-associated cerebral and pulmonary edema requiring ECMO. Case Rep Crit Care 2017;2017:6417012. DOI: 10.1155/2017/6417012.
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