Antiarrhythmic Drugs Are not the Only Option in Electrical Storm: Extracorporeal Membrane Oxygenation as a Life-saving Alternative

Extracorporeal membrane oxygenation has been extensively used for cardiopulmonary support in cardiogenic shock. However, its clinical value in the management of pheochromocytoma crisis remains unclear. We report a rare case of life-threatening cardiogenic shock managed with peripheral venoarterial extracorporeal membrane oxygenation combined with endovascular left ventricular venting, in a 40-year-old female patient, in the setting of unknown adrenal pheochromocytoma. We highlight the life-saving role of extracorporeal membrane oxygenation in undiagnosed endocrine emergencies, allowing cardiac and end-organ recovery, and giving time for accurate diagnosis and specific treatment in such unusual situations.

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A case of recurrent systemic capillary leak syndrome triggered by influenza A infection associated with cardiogenic shock supported by veno-arterial extracorporeal membrane oxygenation

Perfusion ◽

10.1177/02676591211057510 ◽

2021 ◽

pp. 026765912110575

Author(s):

Steven Kin-ho Ling ◽

Natalie Man-chi Fong ◽

Mandy Sze-man Chan

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Cardiogenic Shock ◽

Influenza A ◽

Clinical Suspicion ◽

Capillary Leak Syndrome ◽

Capillary Leak ◽

Systemic Capillary Leak Syndrome ◽

Membrane Oxygenation ◽

Life Saving ◽

Va Ecmo

Systemic capillary leak syndrome (SCLS) is a rare and under-recognized disease which is potentially fatal. We report a case of SCLS triggered by influenza A infection associated with fulminant cardiogenic shock, successfully supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Strong clinical suspicion with appropriate supportive treatment can be life-saving for patients with SCLS.

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Life-saving veno venous extracorporeal membrane oxygenation (VV-ECMO) in a case of potentially fatal massive hemoptysis due to bronchiectasis: a case report

Journal of the Japanese Society of Intensive Care Medicine ◽

10.3918/jsicm.23.324 ◽

2016 ◽

Vol 23 (3) ◽

pp. 324-327

Author(s):

Mitsuhiro Suzuki ◽

Taisuke Yokota ◽

Sayaka Gomei ◽

Tatsuhiko Saiki ◽

Toshirou Kamisasanuki ◽

...

Keyword(s):

Case Report ◽

Extracorporeal Membrane Oxygenation ◽

Massive Hemoptysis ◽

Membrane Oxygenation ◽

Life Saving ◽

Vv Ecmo

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Commentary: From primary graft dysfunction to delayed graft function after heart transplantation with veno-arterial extracorporeal membrane oxygenation: A life-saving approach!

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2019.03.084 ◽

2019 ◽

Vol 158 (6) ◽

pp. 1585-1586

Author(s):

Michel Carrier ◽

Yoan Lamarche

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Heart Transplantation ◽

Graft Function ◽

Delayed Graft Function ◽

Primary Graft Dysfunction ◽

Graft Dysfunction ◽

Membrane Oxygenation ◽

Life Saving

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Extended Indications for Extracorporeal Membrane Oxygenation in the Operating Room

Journal of Intensive Care Medicine ◽

10.1177/0885066619842537 ◽

2019 ◽

Vol 35 (1) ◽

pp. 24-33 ◽

Cited By ~ 2

Author(s):

Barry Kelly ◽

Edmund Carton

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Operating Room ◽

Life Support ◽

Extracorporeal Life Support ◽

Ventricular Tachycardia Ablation ◽

Membrane Oxygenation ◽

Support Organization ◽

Life Saving ◽

Risk Patients ◽

Almost All

Background:The use of extracorporeal life support (ECLS) for cardiorespiratory support is increasing. Traditional absolute contraindications are currently deemed relative contraindications. Extracorporeal life support is now considered for a wider cohort of patients on a case-by-case basis.Method:We performed a review of the literature and examined current Extracorporeal Life Support Organization guidelines that support the use of ECLS in the operating room, based on the underlying pathology and surgical procedure proposed. We discuss specific surgical populations and different modes of ECLS and cannulation strategies.Results:Based on the available literature, veno-venous extracorporeal membrane oxygenation (ECMO) can be used for the management of complex tracheobronchial and lung surgery, both in the elective and in the emergent setting. Elective veno-arterial (V-A) ECMO for cardiocirculatory support should be considered in high-risk patients undergoing ventricular tachycardia ablation. Extracorporeal life support should be considered as a potential life-saving intervention in almost all parturients with severe respiratory failure or refractory cardiogenic shock. V-A ECMO should be considered in unanticipated intraoperative cardiac arrest in patients without preexisting end-organ failure.Conclusion:As the number of indications for ECLS in the operating room is growing, anesthesiology and surgical staff should become familiar with the perioperative management of patients on ECLS.

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Ambulatory Extracorporeal Membrane Oxygenation: Times Are Changing

AACN Advanced Critical Care ◽

10.4037/aacnacc2021604 ◽

2021 ◽

Vol 32 (4) ◽

pp. 434-442

Author(s):

Cristina A. Wojack ◽

Ashleigh G. VanBlarcom ◽

Jesus Casida

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Registered Nurses ◽

Patient Treatment ◽

Past Century ◽

Advanced Practice ◽

Membrane Oxygenation ◽

Life Saving ◽

Advanced Practice Registered Nurses ◽

Lung Failure ◽

Improve Patient

During the past century, medical technology has evolved to enhance quality and quantity of life. Medications, surgeries, and implantable devices have been developed and enhanced to reduce complications and improve patient outcomes. The use of extracorporeal membrane oxygenation is one of the most substantial advances in life-saving modalities. Extracorporeal membrane oxygenation has been widely used for patients with heart or lung failure across the lifespan. Expansion and simplifications of extracorporeal membrane oxygenation circuit designs have informed changes in patient treatment (from bed confinement to ambulatory) and shifted many clinical staffing structures (from cardiovascular perfusionist to nurse-managed care). Highly skilled registered nurses and advanced practice registered nurses are increasingly involved in managing extracorporeal membrane oxygenation in the critical care setting. The purpose of this article is to highlight the technological evolution of extracorporeal membrane oxygenation and the corresponding patient care that bedside registered nurses and advanced practice registered nurses provide.

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Percutaneous extracorporeal membrane oxygenation in electrical storm: five case reports addressing efficacy, transferring allowance or radiofrequency ablation support

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872617730036 ◽

2017 ◽

Vol 7 (5) ◽

pp. 484-489 ◽

Cited By ~ 9

Author(s):

Aitor Uribarri ◽

Loreto Bravo ◽

Javier Jimenez-Candil ◽

Javier Martin-Moreiras ◽

Eduardo Villacorta ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Extracorporeal Membrane Oxygenation ◽

Case Reports ◽

Systemic Circulation ◽

Electrical Storm ◽

Organ Perfusion ◽

Electrical Stability ◽

Medium Term ◽

Membrane Oxygenation ◽

Technological Improvements

Extracorporeal membrane oxygenation systems have undergone rapid technological improvements and are now feasible options for medium-term support of severe cardiac or pulmonary failure. We report five cases of electrical storm that was rescued by the insertion of peripheral veno-arterial extracorporeal membrane oxygenation systems. This device could help to restore systemic circulation as well as permitting organ perfusion in patients with cardiogenic shock in relation to electrical storm thus achieving greater electrical stability. Also, in some cases extracorporeal membrane oxygenation support could facilitate electrophysiology study.

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