ArticleCase reports in critical care2017
A Case of MDMA-Associated Cerebral and Pulmonary Edema Requiring ECMO.
Article in Case reports in critical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Rare but relevant: MDMA and hyponatraemia.Addiction (Abingdon, England) · 2026Review
- Neurogenic Pulmonary Edema Associated with Hyponatremia, Primary Polydipsia, and Cannabis Use: A Case Report.Clinical practice and cases in emergency medicine · 2024Article
- A case report of successful rescue using veno-arterial extracorporeal membrane oxygenation: managing cerebral-cardiac syndrome.Frontiers in cardiovascular medicine · 2024Article
- Extracorporeal Membrane Oxygenation Support in Refractory Multi-organ Failure by 3,4-Methylenedioxymethamphetamine Intoxication ("Ecstasy").Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Methylenedioxymethamphetamine (MDMA)-Induced Hyponatremia: Case Report and Literature Review.Cureus · 2021Article
- COVID-19-Associated Acute Brain Dysfunction Related to Sepsis.Journal of clinical medicine research · 2021Review
- Neuronal and peripheral damages induced by synthetic psychoactive substances: an update of recent findings from human and animal studies.Neural regeneration research · 2020Review
- Case of Cardiac Arrest Treated with Extra-Corporeal Life Support after MDMA Intoxication.Case reports in critical care · 2019Article
- Individuals with Hyperthyroidism are More Susceptible to having a Serious Serotonin Syndrome Following MDMA (Ecstasy) Administration in Rats.Annals of forensic research and analysis · 2018Article
- Neurogenic pulmonary edema in a child with traumatic epidural hematoma and brain herniation.Saudi journal of anaesthesiaArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A 20-year-old female presented with confusion, generalized tonic-clonic seizures, and severe hyponatremia after ingesting 3,4-methylenedioxymethamphetamine (MDMA). Brain computed tomography (CT) demonstrated cerebral edema. Her hospital course was rapidly complicated by respiratory failure and shock requiring intubation and vasopressors. Refractory acute respiratory distress syndrome (ARDS) was diagnosed which was unresponsive to conventional and salvage therapies, requiring initiation of extracorporeal membrane oxygenation (ECMO), leading to normalization of oxygenation parameters. Hyponatremia was corrected and the encephalopathy resolved. The patient was decannulated and extubated after three days. MDMA-induced hyponatremia is hypothesized to result from enhanced serotonergic activity and arginine vasopressin (AVP) release in the brain leading to hyperthermia-induced polydipsia and syndrome of inappropriate antidiuretic hormone (SIADH) secretion. A common but often unrecognized complication of severe hyponatremia is the Ayus-Arieff syndrome where cerebral edema causes neurogenic pulmonary edema via centrally mediated increases in catecholamine release and capillary injury. For our patient, ECMO was required for three days while the hyponatremia was corrected which led to rapid clearing of the cerebral edema and neurogenic pulmonary edema. This case illustrates that, in selecting patients with refractory ARDS from MDMA-associated cerebral and pulmonary edema, ECMO may be a temporizing and life-saving modality of treatment.
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Registered trials
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