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A case series of six patients is described in this article, all of whom developed various bleeding complications while receiving heparin or bivalirudin for thrombosis prophylaxis. The patients had a medical history of acute respiratory distress syndrome (ARDS) secondary to COVID-19 and were scheduled for lung transplants. Bleeding events included oozing from central venous catheters, bleeding from the femoral site, epistaxis, and bleeding from various other sites. Some patients also experienced lack of efficacy with bivalirudin. The article provides detailed information about each patient's treatment and outcomes. [Extracted from the article]

A case report from the journal Reactions Weekly describes the experience of a 20-year-old man who exhibited lack of efficacy and misuse of multiple drugs. The man was being treated for hypertension and aluminum phosphide poisoning, but experienced vomiting, nausea, headache, hypertension, chest and abdominal pain despite treatment. His condition worsened, leading to respiratory failure, hypotension, and refractory cardiogenic shock. He required mechanical ventilation, renal replacement therapy, and extracorporeal membrane oxygenation. After 34 days of hospitalization, his condition stabilized and he was discharged home. [Extracted from the article]

A 24-year-old man with anti-MDA5 dermatomyositis exhibited lack of efficacy during treatment with cyclophosphamide, tacrolimus, and unspecified steroids. He initially presented with a purpuric rash, followed by fever, flu-like symptoms, and dark urine. Extensive investigations revealed lung abnormalities and lymphadenopathy, leading to a diagnosis of anti-MDA5 dermatomyositis. Despite treatment, his respiratory condition worsened, requiring intubation and transfer to another facility for extracorporeal membrane oxygenation (ECMO) support. [Extracted from the article]

An 84-year-old woman experienced ventricular arrhythmias after taking pilsicainide for paroxysmal supraventricular tachycardia (SVT). Despite treatment with magnesium and potassium, her condition did not improve. Her therapy with pilsicainide was discontinued, and she was admitted to the ICU where she received IV lidocaine and venoarterial extracorporeal membrane oxygenation (VA-ECMO). Her condition eventually improved, and it was confirmed that the ventricular arrhythmias were caused by pilsicainide intoxication and poisoning. [Extracted from the article]

A retrospective study of 179 patients conducted between 2015 and 2019 found that three patients experienced a lack of efficacy while being treated with aciclovir for cytomegalovirus (CMV) prophylaxis. Two of these patients also experienced a lack of efficacy with antithymocyte globulin for graft-versus-host disease (GvHD) prophylaxis. The patients, who had different types of leukemia, were scheduled for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Despite receiving CMV prophylaxis and GvHD prophylaxis, the patients developed CMV-related complications and GvHD. One patient experienced remission, while another died due to CMV encephalitis, and the third patient died due to CMV pneumonia. [Extracted from the article]

A 47-year-old woman with undifferentiated inflammatory arthritis and anti-MDA5 dermatomyositis experienced a lack of efficacy with methotrexate and methylprednisolone. She initially presented with symptoms such as fingertip erythema, thigh rash, joint swelling, dry cough, and reduced exercise tolerance. Despite treatment, her condition worsened, leading to pneumonia and rapidly progressive interstitial lung disease. She was transferred to a tertiary center for extracorporeal membrane oxygenation but unfortunately died shortly after. The lack of improvement with methotrexate and methylprednisolone was considered in her case. [Extracted from the article]

A 71-year-old woman with a history of heart conditions experienced a lack of efficacy during treatment for cardiogenic shock. She had multiple heart issues, including aortic stenosis, aortic regurgitation, mitral valve regurgitation, and tricuspid regurgitation. Despite receiving various medications, including epinephrine, norepinephrine, milrinone, and vasopressin, her condition did not improve. She underwent a transcatheter aortic valve replacement and had temporary mechanical circulatory support with an Impella device. However, she later developed bleeding complications and ultimately passed away. [Extracted from the article]

A 40-year-old man with a history of asthma experienced a lack of efficacy with aminophylline, glucose, and methylprednisolone treatment. He had been using salbutamol and budesonide inhalers regularly but was admitted to the hospital after his symptoms worsened. Despite receiving multiple interventions, including mechanical ventilation and various medications, his condition continued to deteriorate. Eventually, he was diagnosed with an Aspergillus infection and treated with voriconazole, which successfully resolved his symptoms. After discharge, follow-up tests showed improvement in his lung cavities. [Extracted from the article]

A 40-year-old woman with type-1 diabetes mellitus developed infective endocarditis (IE) secondary to Corynebacterium striatum while undergoing immunosuppressive therapy and off-label treatment for COVID-19. The woman had received a simultaneous pancreas-kidney transplantation and was taking prednisolone, tacrolimus, and everolimus. After being diagnosed with COVID-19, she received oxygen therapy, remdesivir, and off-label treatment with dexamethasone. Her condition worsened, and she developed septic acute respiratory distress syndrome. She was treated with antibiotics and underwent valve replacement surgery, eventually recovering and being discharged. The IE was attributed to the medications she was taking. [Extracted from the article]

A 46-year-old woman with pulmonary arterial hypertension (PAH) experienced a lack of efficacy during treatment with multiple drugs, including epoprostenol, macitentan, nitric-oxide, tadalafil, and treprostinil. Despite changes in therapy and receiving epoprostenol and nitric-oxide, she progressed to right ventricular failure and shock. She underwent a lung transplant evaluation and received venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a bridge to transplant. However, she developed complications and ultimately died from acute severe cardiogenic shock with multi-system organ failure. The lack of efficacy of treprostinil, tadalafil, and macitentan was considered in her case. [Extracted from the article]

This article describes two case reports of neonates who experienced a lack of efficacy during treatment with epinephrine, dobutamine, and immune-globulin. In the first case, a premature neonate developed symptoms such as fever, lethargy, and difficulty drinking, and eventually experienced cardiac arrest and died due to coxsackievirus B1 myocarditis. In the second case, another premature neonate developed abdominal distension and respiratory distress, and was diagnosed with CVB1 myocarditis. Despite receiving immune-globulin therapy, her condition worsened before eventually improving with unspecified interventions. [Extracted from the article]

A 28-year-old man experienced lack of efficacy after using cisatracurium-besilate and heparin off-label for SARS-CoV-2 infection. He initially presented with upper respiratory symptoms and was diagnosed with the infection. Despite receiving mechanical ventilation and cisatracurium-besilate, his condition worsened, leading to acute respiratory distress syndrome (ARDS). He required extracorporeal membrane oxygenation (ECMO) and eventually underwent a double-lung transplantation, which resulted in significant improvement in oxygenation. He experienced some complications, but ultimately showed preserved pulmonary function and was discharged without complications. [Extracted from the article]

A 46-year-old man with a medical history of diabetes, chronic obstructive pulmonary disease (COPD), and acute respiratory failure was admitted to the hospital for pneumonia. After being treated with piperacillin/tazobactam for pneumonia caused by Pseudomonas aeruginosa, he was discharged. However, he later presented with elevated white blood cells and worsening chest radiography. He was readmitted and started on antifungal treatment with amphotericin-B due to suspicion of fungal infection. Despite receiving amphotericin-B, his respiratory status continued to decline, and he developed acute respiratory distress syndrome, indicating a lack of efficacy with the medication. The man's poorly controlled diabetes and active smoking with COPD made him more susceptible to bacterial and fungal infections. [Extracted from the article]

A 46-year-old woman experienced lack of efficacy during treatment with vancomycin and piperacillin/tazobactam for a Klebsiella pneumoniae infection. She was admitted to the hospital with fever and cough, and her condition worsened with respiratory distress, leading to intubation. After consultation, she was diagnosed with catastrophic antiphospholipid syndrome and received plasma exchange, steroids, and anticoagulation. Despite treatment, her condition continued to deteriorate, and she eventually underwent a bilateral lung transplant. Unfortunately, she died due to post-transplant complications. [Extracted from the article]

A 45-year-old woman experienced drug toxicity after overdosing on metformin for diabetes. She suffered from convulsive seizures, metformin-associated lactic acidosis (MALA), cardiac arrest, and vasoplegic shock. Despite treatment with epinephrine, norepinephrine, and vasopressin, her condition did not improve. She was given a single dose of IV methylthioninium-chloride (methylene blue) for drug toxicity, which temporarily improved her blood pressure and lactate levels. However, she ultimately died on the 10th day due to vasoplegic shock and MALA caused by metformin toxicity and overdose. [Extracted from the article]

A 38-year-old woman with breast cancer experienced a lack of efficacy during treatment for various heart conditions. She initially received vasopressors for complete heart block, but later developed ventricular tachycardia storm despite resuscitation efforts. Treatment with lidocaine and amiodarone also failed, leading to cardiac arrest. She was stabilized with advanced cardiovascular life support and extracorporeal membrane oxygenation, but her ventricular fibrillation did not respond to defibrillation attempts. Eventually, she was diagnosed with biventricular failure and fulminant myocarditis and treated with steroids, which resulted in improvement. [Extracted from the article]

A 47-year-old woman with asthma experienced a lack of efficacy during treatment with various medications, including epinephrine, magnesium sulfate, ketamine, β-adrenergic-receptor-agonists, and corticosteroids. Despite receiving these treatments, her condition did not improve, and she required intubation. Additional interventions, such as femoral-jugular venovenous extracorporeal membrane oxygenation (VV-ECMO) and radiotherapy, were attempted, but the woman ultimately succumbed to widespread cancer metastasis. The article provides a detailed account of the patient's medical history and treatment, highlighting the challenges faced in managing her condition. [Extracted from the article]

A 7-year-old girl with macrophage activation syndrome and respiratory failure received multiple treatments including dexamethasone, methylprednisolone, immune-globulin, eculizumab, plasma, anakinra, rituximab, tacrolimus, and cyclophosphamide. Despite these treatments, her condition worsened and she eventually died from macrophage activation syndrome and juvenile dermatomyositis. The case suggests a lack of efficacy of the drugs used in treating her condition. [Extracted from the article]

This article from Reactions Weekly describes two case reports of patients who experienced a lack of efficacy while being treated with heparin for thrombosis prophylaxis. The first patient, a 45-year-old man with severe acute respiratory distress syndrome (ARDS) due to COVID-19, developed cannula-associated deep vein thrombosis (CaDVT) despite receiving heparin. The second patient, a 53-year-old man with ARDS due to COVID-19, also developed CaDVT despite heparin treatment. Both patients had complicated hospital courses and experienced various medical complications. These case reports highlight the need for further research on the efficacy of heparin in preventing thrombosis. [Extracted from the article]

A 58-year-old man experienced heparin-induced thrombocytopenia while being treated with heparin as an anticoagulant therapy. The man was admitted to the hospital for cardiogenic shock and underwent various procedures, including percutaneous coronary intervention and ventricular tachycardia ablation. He started receiving heparin but developed heparin-induced thrombocytopenia, leading to the discontinuation of heparin. Eventually, his platelet count recovered, and he underwent a heart transplantation. [Extracted from the article]

A 60-year-old man with mixed connective tissue disease and interstitial lung disease-related end-stage lung disease underwent a bilateral lung transplant. After the surgery, he developed adenovirus pneumonitis and was treated with cidofovir. However, the treatment was not effective, and he ultimately died from adenovirus pneumonitis and progressive respiratory failure. [Extracted from the article]

A 74-year-old woman experienced heparin-induced thrombocytopenia (HIT) while being treated with heparin for anticoagulation therapy. She also showed a lack of effectiveness when treated with argatroban for a mid-right coronary artery occlusion. Despite repeated attempts to clear the coronary obstruction, the patient's condition did not improve. She eventually required veno-arterial extracorporeal membrane oxygenation (VA-ECMO) due to HIT. The woman was discharged with independent mobility and no major neurological issues. [Extracted from the article]

A 28-year-old man experienced severe toxic effects after intentionally overdosing on amlodipine, a medication prescribed to his mother. He presented to the emergency room with altered mental status, hypotension, hypothermia, and shock. Despite receiving fluids and vasopressors, his condition worsened, leading to vasoplegia and multi-organ dysfunction. He was treated with insulin and placed on venoarterial extracorporeal membrane oxygenation (ECMO). Eventually, his symptoms improved, and he was discharged home. The toxic effects were attributed to the intentional overdose of amlodipine. [Extracted from the article]

A case report describes the toxic effects of an intentional overdose of bupropion in a 32-year-old transgender man with a history of substance use disorder, depression, and HIV. The patient experienced seizures, decreased mental status, cardiogenic shock, and ventricular arrhythmias. Treatment included antiepileptic drugs, intubation, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) cannulation, electrical cardioversion, lidocaine therapy, and psychiatric rehabilitation. The patient eventually recovered and was discharged. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventIn a single-center retrospective study involving 168 patients conducted between 2013 to 2023; one patient [age and sex not stated] was described, who developed haemorrhagic stroke during treatment with bivalirudin as an anticoagulant therapy during extracorporeal membrane oxygenation [route, dosage, duration of treatment to reaction onset and outcome not stated]. [Extracted from the article]

A case report published in Reactions Weekly describes the lack of efficacy of multiple drugs in the treatment of a 0.07-year-old girl with Bordetella pertussis (B. pertussis) infection. The girl was also co-infected with Staphylococcus aureus, rhinovirus, and enterovirus. Despite receiving treatment with meropenem, vancomycin, and azithromycin, the girl showed a high level of B. pertussis infection and developed renal failure, severe hyperkalemia, and hypocalcemia with hyperphosphatemia. Additional treatments, including nitric oxide inhalation, unspecified pulmonary vasodilators, and haemodynamic support therapy with epinephrine and norepinephrine, were also ineffective. The girl ultimately died due to cardiac arrest and B. pertussis infection. [Extracted from the article]

A case series published in Reactions Weekly describes a 64-year-old man who experienced a lack of efficacy when treated with epinephrine and norepinephrine for acute diastolic hypotension. The man had a history of nonischemic dilated cardiomyopathy and underwent a heart transplant. He was hospitalized due to COVID-19-induced transplant rejection and received extracorporeal membrane oxygenation (ECMO) and plasma exchange. Despite treatment with epinephrine and norepinephrine, the patient's condition worsened, and he developed symptoms of alpha-gal syndrome. He ultimately died of sepsis several weeks later. [Extracted from the article]

A case series of seven pediatric patients with pulmonary hypertension (PH) who received off-label treatment with selexipag or treprostinil was described. The patients experienced various side effects, including facial flushing, decreased appetite, intermittent diarrhea, headache, nausea, stomach pain, and central venous line-related complications. Despite these side effects, some patients showed improvement in their functional status and endurance after six months of treatment. However, further research is needed to fully understand the efficacy and safety of these medications for pediatric PH. [Extracted from the article]

A 27-year-old man experienced lack of efficacy and liver injury while being treated for thyrotoxicosis. He presented with symptoms such as palpitations and difficulty breathing, and was found to have an elevated heart rate and blood pressure. The man's condition worsened, leading to complications such as heart failure, respiratory distress syndrome, and acute renal failure. After several weeks of treatment, his condition improved and he was able to undergo further procedures for his condition. [Extracted from the article]

A 60-year-old man with a history of arterial hypertension and overweight experienced lack of efficacy during treatment with prednisolone and nitric-oxide for acute respiratory distress syndrome. After being hospitalized for a flu-like syndrome, his condition worsened despite receiving prednisolone, leading to intubation and mechanical ventilation. He was later diagnosed with COVID-19 and diastolic dysfunction, and received off-label treatments for both conditions. Despite treatment with inhalation nitric-oxide, his severe hypoxia persisted. Eventually, he was diagnosed with bronchopneumonia and acute immuno-depression syndrome, and received appropriate treatments. With treatment, his condition improved, and he was discharged from the hospital. [Extracted from the article]

This article discusses three cases of infants with status epilepticus who experienced toxicities and lack of efficacy with multiple drugs. In the first case, the patient had seizures that were unresponsive to lorazepam, phenobarbital, fosphenytoin, midazolam, ketamine, and pentobarbital. The second case involved a patient with seizures that were uncontrolled with lorazepam, phenobarbital, fosphenytoin, levetiracetam, midazolam, and ketamine. The third case resulted in the patient's death despite treatment with lorazepam, pentobarbital, levetiracetam, fosphenytoin, phenobarbital, midazolam, and ketamine. Lack of efficacy was observed with all of these drugs in all three cases. [Extracted from the article]

A 35-year-old man experienced cardiac arrest after receiving sulfur-hexafluoride for ECG enhancement. He also showed lack of efficacy when treated with various medications for venous thromboembolism prophylaxis and cardiac arrest. The man had a history of multiple sclerosis, obesity, and other medical conditions. Despite receiving multiple interventions, including epinephrine and extracorporeal membrane oxygenation, he ultimately died from the cardiac arrest. [Extracted from the article]

A 46-year-old man with a medical history of hypertension, poorly controlled diabetes, chronic obstructive pulmonary disease, and current tobacco use presented to a rural clinic with various symptoms. He was diagnosed with Pseudomonas infection and received treatment with levofloxacin and piperacillin/tazobactam, but his condition worsened. Further investigations revealed a Blastomyces dermatitidis infection, and he was treated with itraconazole and amphotericin-B-liposomal. However, despite these treatments, his respiratory failure and acute respiratory distress syndrome (ARDS) worsened, and he ultimately passed away. The lack of efficacy of the medications used was observed in this case. [Extracted from the article]

A 57-year-old man experienced a lack of efficacy during treatment for ventricular fibrillation (VF) with amiodarone, potassium, magnesium, and bisoprolol. Despite initial responsiveness to treatment, his VF recurred, leading to the use of deep sedation, intubation, and venoarterial extracorporeal membrane oxygenation. Ultrasound-guided percutaneous left stellate ganglion block was performed, followed by a single DC shock, which resulted in stable sinus rhythm. However, he later developed severe cardiogenic shock and monomorphic VF, leading to the implantation of a subcutaneous implantable cardioverter defibrillator (sICD). [Extracted from the article]

A 42-year-old man in Romania was admitted to the hospital after being found unconscious in a canal. He was diagnosed with severe hypothermia and experienced various complications, including cardiac arrest and ventricular fibrillation. He was treated with anticoagulation therapy using heparin, which led to the development of a bladder bleeding hematoma. The hematoma was investigated but no specific source of bleeding was found. The man's post-operative course was favorable, and he eventually recovered and was discharged from the hospital. [Extracted from the article]

A 43-year-old woman with chronic thromboembolic pulmonary hypertension (CTEPH) experienced a lack of efficacy during treatment with epoprostenol, tadalafil, anticoagulation treatment, and inotropic agents. Despite receiving continuous IV anticoagulation, increased inotropic agents, and careful introduction of epoprostenol and tadalafil, she developed refractory right-sided heart failure. She was subsequently treated with veno-arterial extracorporeal membrane oxygenation (V-A ECMO), high-dose steroids for catastrophic antiphospholipid syndrome, and rescue balloon pulmonary angioplasty (BPA) procedures. She was eventually discharged on warfarin with improved symptoms. [Extracted from the article]

A 43-year-old woman experienced hypotension after overdosing on verapamil. She had a medical history of bipolar and personality disorder and was admitted to the hospital with an overdose of verapamil. She required mechanical support with venoarterial extracorporeal membrane oxygenation (VA-ECMO) due to profound vasoplegic shock. The woman also had severe left ventricular systolic dysfunction and received impella for left ventricular venting. After a multidisciplinary discussion, her treatment was upgraded to a VA-V configuration, which resulted in an improvement in her condition. [Extracted from the article]

A 32-year-old pregnant woman experienced a lack of effectiveness in her treatment for hypotension. She had a history of gestational diabetes and presented with chest pain. Despite receiving various medications, her chest pain could not be controlled and she underwent an emergency cesarean delivery. The newborn had low birth weight and experienced apnea, pale skin, and a weak heartbeat. The woman's blood pressure remained low even after receiving high doses of multiple drugs. Eventually, she was diagnosed with left adrenal pheochromocytoma and underwent laparoscopic surgery. After one week, her symptoms improved and she was discharged. [Extracted from the article]

A 24-year-old woman experienced a lack of efficacy during treatment for a lung infection. She was admitted to a hospital in the USA for acute respiratory failure and required mechanical ventilator support. The woman had a history of vaping and exposure to chicken feces and blood. Despite receiving treatment with fluconazole, levofloxacin, and piperacillin/tazobactam, there was no significant improvement in her condition, and she remained on extracorporeal membrane oxygenation support. [Extracted from the article]

A study was conducted on 17 patients with extrapulmonary mycobacterium abscessus complex (MABC) infection who exhibited lack of efficacy during treatment with various drugs. One patient developed optic neuropathy during treatment with linezolid and nephrotoxicity during treatment with amikacin. Several patients died due to the lack of efficacy of the drugs. The study provides detailed information about each patient's medical history, treatment, and outcome. [Extracted from the article]

A 26-year-old man who had previously undergone a renal transplant developed COVID-19 infection after receiving immunosuppressant therapy. Despite treatment with various medications, including remdesivir, baricitinib, and convalescent-anti-SARS-CoV-2-plasma, the patient experienced a lack of efficacy and developed complications such as respiratory failure, gastrointestinal bleeding, and thrombocytopenia. However, his condition eventually improved. The article highlights the challenges of treating COVID-19 in patients who are immunocompromised due to previous organ transplants. [Extracted from the article]

A 6-month-old girl experienced a lack of efficacy during treatment with meropenem and vancomycin for a Pseudomonas aeruginosa infection. She was initially admitted to the hospital and received ceftriaxone and vancomycin, but her condition worsened rapidly. She developed respiratory failure and required intubation and vasopressor support. Despite being upgraded to meropenem and vancomycin, she experienced cardiac arrest and ultimately passed away due to respiratory and multiorgan failure caused by disseminated Pseudomonas infection. This case highlights the lack of efficacy of the antibiotics in treating the infection. [Extracted from the article]

An 8-year-old girl with atrial fibrillation (AF) was treated with metoprolol and amiodarone, but the treatment was ineffective. She was admitted to the hospital after experiencing cardiac arrest and received epinephrine to revive her. Despite further interventions, including extracorporeal membrane oxygenation (ECMO), her condition worsened and she developed persistent AF, heart failure, and cardiac shock, ultimately resulting in her death. The cause of her condition was determined to be restrictive cardiomyopathy (RCM) with a novel de novo TNNI3 gene mutation. [Extracted from the article]

A 72-year-old man experienced a lack of efficacy during treatment with amiodarone for atrial fibrillation (AF). He presented with hypotension, decreased urinary output, and worsening shortness of breath. After being diagnosed with AF and non-obstructive coronary artery disease, he underwent right heart catheterization and developed profound cardiogenic shock. Despite receiving chemical cardioversion with amiodarone, the treatment was unsuccessful. Eventually, the man underwent ablation while on venoarterial extracorporeal membrane oxygenation (VA-ECMO), and his condition improved after maintaining sinus rhythm. [Extracted from the article]

In a retrospective study of 18 pregnant female patients, it was found that some developed various adverse reactions while receiving anticoagulation therapy with heparin or bivalirudin. These reactions included haemorrhagic shock, gastrointestinal bleeding, subarachnoid haemorrhage, thrombocytopenia, haemolytic anaemia, and left frontal lobe haemorrhage. One patient unfortunately died from haemorrhagic shock. Another patient who developed heparin-induced thrombocytopenia with haemolytic anaemia switched to bivalirudin but experienced haemorrhagic conversion of a left occipital infarct. However, some patients did see improvement or resolution of their adverse events without intervention. [Extracted from the article]

A 39-year-old man with interstitial pneumonia and pulmonary hypertension exhibited lack of efficacy during treatment with nintedanib, methylprednisolone, pirfenidone, and sildenafil. Despite receiving these medications, his symptoms did not improve. He was transferred to another hospital for a lung transplant and underwent various treatments, including tracheal intubation, ventilation, and extracorporeal membrane oxygenation. His symptoms improved after tracheostomy but later developed respiratory failure, which was managed with steroid pulse therapy. [Extracted from the article]

A 38-year-old pregnant woman with poorly controlled asthma developed hyperkalaemia and wide QRS complexes after being treated with suxamethonium-chloride for emergent intubation. Despite receiving various treatments, including calcium-gluconate, sodium-bicarbonate, insulin drip, sodium-polystyrene-sulfonate, and inhaled isoflurane, her condition worsened and she required extracorporeal membrane oxygenation. However, she eventually delivered a healthy child. [Extracted from the article]

A case report describes the lack of efficacy of avibactam/ceftazidime in the treatment of a female neonate with Klebsiella pneumoniae. The neonate was born extremely preterm and had a history of respiratory failure and necrotising enterocolitis. She also had a COVID-19 pneumonia diagnosis and was receiving various treatments, including avibactam/ceftazidime. Despite these interventions, she remained in critical condition and ultimately died due to the infection, metabolic acidosis, and haemodynamic instability. This case highlights the challenges in treating neonates with severe infections and the need for further research in this area. [Extracted from the article]

A 79-year-old man experienced severe refractory hypoxemia, hypercapnic respiratory failure, and severe shock after receiving protamine-sulfate for heparin reversal during a surgical procedure. This led to a sudden deterioration in his cardiopulmonary status, resulting in increased ventilator pressure, pulmonary edema, and severe acidemia. The patient was managed with ventilator adjustments, vasoactive agents, and volume resuscitation, but his condition continued to worsen. He was eventually placed on extracorporeal membrane oxygenation, which stabilized his hemodynamic and respiratory functions. After 48 hours on extracorporeal membrane oxygenation, he was successfully weaned off and discharged home after 23 days with a full recovery. [Extracted from the article]

A 14-year-old girl experienced drug poisoning after intentionally overdosing on verapamil. She exhibited symptoms such as atrioventricular block, hypotension, bradycardia, and hyperglycemia. Despite treatment with calcium gluconate, epinephrine, and norepinephrine, her condition did not improve. She was eventually transferred to a pediatric intensive care unit where she required high doses of vasoactive medications and was placed on venoarterial extracorporeal membrane oxygenation (VA-ECMO). After undergoing therapeutic plasma exchange, her vasoactive needs were gradually reduced, and she was eventually transferred to an inpatient psychiatric facility after five days. [Extracted from the article]