Life‐threatening acute liver failure and myocarditis needing extracorporeal membrane oxygenation: Could it be therapeutic misadventure with paracetamol?

2021 ◽  
Author(s):  
Nitin Mohan ◽  
Nitesh Singhal ◽  
Michael O Stormon ◽  
Philip N Britton ◽  
Matthew Liava'a ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Membrane Oxygenation ◽  
Life Threatening

scholarly journals A Case of Exertional Heat Stroke Complicated by Hypoxic Hepatitis

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Bertram K. Woitok ◽  
Shawki Bahmad ◽  
Gregor Lindner
Keyword(s):  
Supportive Care ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Multiorgan Failure ◽  
Heat Stroke ◽  
Exertional Heat Stroke ◽  
Hypoxic Hepatitis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Delayed Referral

Background.Exertional heat stroke is a life-threatening condition often complicated by multiorgan failure. We hereby present a case of a 25-year-old male presenting with syncope after a 10  km run in 28°C outside temperature who developed acute liver failure. Case Presentation. Initial temperature was found to be 41.1°C, and cooling measures were rapidly applied. He suffered from acute renal failure and rhabdomyolysis and proceeded to acute liver failure (ASAT 6100 U/l and ALAT 6561 U/l) due to hypoxic hepatitis on day 3. He did not meet criteria for emergency liver transplantation and recovered on supportive care. Conclusions. Acute liver failure due to heat stroke is a life-threatening condition with often delayed onset, which nevertheless resolves on supportive care in the majority of cases; thus, a delayed referral to transplant seems to be reasonable.

Extracorporeal membrane oxygenation in pheochromocytoma-induced cardiogenic shock

2017 ◽  
Vol 26 (4) ◽  
pp. 314-316 ◽  
Author(s):  
Nadia Bouabdallaoui ◽  
Denis Bouchard ◽  
E. Marc Jolicoeur ◽  
Alexandra Chronopoulos ◽  
Pierre Y Garneau ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Specific Treatment ◽  
Left Ventricular ◽  
Clinical Value ◽  
Membrane Oxygenation ◽  
Cardiopulmonary Support ◽  
Life Saving ◽  
Adrenal Pheochromocytoma ◽  
Life Threatening

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.

scholarly journals Extracorporeal membrane oxygenation (ECMO) for COVID-19 patients

2021 ◽  
Author(s):  
Surat Tongyoo ◽  
Suneerat Kongsayreepong
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Ecmo Support ◽  
Janus Kinase ◽  
Systemic Steroid ◽  
Heparin Infusion ◽  
Membrane Oxygenation ◽  
Rescue Treatment ◽  
Threatening Condition ◽  
Life Threatening ◽  
The Individual

During the current outbreak of coronavirus disease 2019 (COVID-19), Extracorporeal Membrane Oxygenation (ECMO) support could be considered as the rescue treatment from life threatening condition among severe COVID-19 patients who did not respond to mechanical ventilation. We propose that veno-venous ECMO should be considered if patient has persistence PaO2:FiO2 ratio lower than 100 mmHg after appropriate mechanical ventilator adjustment, muscle relaxant and prone position. During ECMO support, treatment against cytokine storm, including non-selective immune suppression with systemic steroid, or selective interleukin-6 inhibition and Janus Kinase inhibition should be considered. Heparin infusion is still the recommended anticoagulant to maintain activated partial thromboplastin time (APTT) ratio range 1.5-2.0. The overall hospital mortality was comparable with respiratory failure patients, requiring ECMO support from other causes, which was reported about 37-50%. The decision to initiate ECMO could be depended on the individual hospital capacity and treatment availability.

scholarly journals Bronchotracheal Stenting Management by Rigid Bronchoscopy under Extracorporeal Membrane Oxygenation (ECMO) Support: 10 Years of Experience in a Tertiary Center

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Sabrina Meyer ◽  
Anne-Sophie Dincq ◽  
Lionel Pirard ◽  
Sebahat Ocak ◽  
Jean-Paul D’Odémont ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Rigid Bronchoscopy ◽  
Ecmo Support ◽  
Membrane Oxygenation ◽  
Tertiary Center ◽  
Airway Stenting ◽  
Life Threatening ◽  
Venovenous Ecmo ◽  
Central Airway

Purpose. Airway stenting offers good palliation and improves the quality of life in patients with inoperable bronchotracheal stenosis. However, in some cases, the management of stenting can be life-threatening. Hence, a strategy for maintaining oxygenation and hemodynamic stability should be anticipated to avoid critical situations. Herein, we report the use of extracorporeal membrane oxygenation (ECMO) in bronchotracheal stenting management to secure oxygenation and facilitate interventions. Methods. We retrospectively reviewed all patients who underwent rigid bronchoscopy under ECMO support for the management of bronchotracheal stenting at CHU UCL Namur hospital (Belgium), between January 2009 and December 2019. Results. We included 14 bronchoscopy cases performed on 11 patients (3 patients underwent 2 bronchoscopies) in this study; 12 were performed on males and 2 on females. The median age was 54 years. There were 11 benign and 3 malignant etiologies for the central airway obstruction/stenosis. Eight cases were supported by venovenous ECMO and six by venoarterial ECMO. The median ECMO time was 267 minutes. The weaning of ECMO support was successful in all cases. In most cases, the procedures were performed effectively and safely. Only two local complications caused by the cannulation of ECMO were reported, and anticoagulation was adapted to avoid bleeding at the operating site and clot formation in the system. Conclusion. Elective ECMO support was helpful and safe for the high-risk management of bronchotracheal stenting with rigid bronchoscopy and was not associated with any additional significant complications.

Life-threatening antineutrophil cytoplasmic antibody–associated vasculitis after influenza A H1N1 infection requiring veno-venous extracorporeal membrane oxygenation

Perfusion ◽  
2020 ◽  
Vol 35 (6) ◽  
pp. 546-549
Author(s):  
Frantzeska G. Frantzeskaki ◽  
Stavros Dimopoulos ◽  
Dimitrios Konstantonis ◽  
Pelagia Katsibri ◽  
Kostantinos Kostopanagiotou ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Influenza A ◽  
Immunosuppressive Treatment ◽  
Pulmonary Hemorrhage ◽  
Antineutrophil Cytoplasmic Antibody ◽  
H1n1 Infection ◽  
Membrane Oxygenation ◽  
Antineutrophil Cytoplasmic Autoantibody ◽  
Influenza A H1n1 ◽  
Life Threatening

Introduction: Antineutrophil cytoplasmic autoantibody–associated vasculitis is an immune-mediated necrotizing vasculitis, affecting small- and medium-sized vessels. Case report: A 22-year-old female patient with free medical history presented with life-threatening pulmonary hemorrhage due to antineutrophil cytoplasmic autoantibody–associated vasculitis, temporarily associated with influenza A H1N1 infection. Due to rapidly worsening respiratory failure, despite conventional management, veno-venous peripheral extracorporeal membrane oxygenation was initiated and continued for 26 days, with subsequent renal replacement therapy. Discussion: We present a case of severe antineutrophil cytoplasmic autoantibody–associated pulmonary vasculitis, managed with veno-venous extracorporeal membrane oxygenation at the initial phase. Despite the significant challenges raised with the use of extracorporeal membrane oxygenation in pulmonary hemorrhage cases, extracorporeal membrane oxygenation may have a significant impact on outcome in this setting, by providing adequate time for a successful immunosuppressive treatment.

Extracorporeal membrane oxygenation for Kawasaki disease: two case reports and the Extracorporeal Life Support Organization experience 1999–2015

Perfusion ◽  
2017 ◽  
Vol 32 (7) ◽  
pp. 609-612 ◽  
Author(s):  
Derek Best ◽  
Johnny Millar ◽  
Igor Kornilov ◽  
Yury Sinelnikov ◽  
Roberto Chiletti ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Extracorporeal Membrane Oxygenation ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Case Reports ◽  
Membrane Oxygenation ◽  
Support Organization ◽  
Life Threatening ◽  
Acute Kawasaki Disease ◽  
Cardiac Manifestations

Kawasaki disease is usually a limited illness of early childhood. However, life-threatening cardiac manifestations can occur, either at acute presentation or as a consequence of coronary arterial involvement. We report the successful use of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) for cardiac support in two children with Kawasaki disease: one with acute Kawasaki disease shock syndrome, the other with complications of coronary arteritis and subsequent surgery. We also reviewed the reported experience in the ELSO database and available literature.

scholarly journals Central Airway Obstruction due to Mediastinal Malignant Lymphoma Requiring Venovenous-Extracorporeal Membrane Oxygenation

2019 ◽  
Vol 2 (2) ◽  
pp. 42-47 ◽  
Author(s):  
Yoshihiro Ueda ◽  
Ichiro Hirayama ◽  
Ryohei Horie ◽  
Kent Doi ◽  
Naoto Morimura
Keyword(s):  
Intensive Care ◽  
Extracorporeal Membrane Oxygenation ◽  
Airway Obstruction ◽  
Malignant Lymphoma ◽  
Hematological Malignancy ◽  
Central Airway Obstruction ◽  
Membrane Oxygenation ◽  
Life Threatening ◽  
Central Airway ◽  
Ecmo Therapy

Extracorporeal membrane oxygenation (ECMO) therapy might be controversial when patients with advanced malignant disease develop heart or lung failure refractory to conventional management. Especially as for the hematological malignancy patients, the induction of ECMO therapy must be considered carefully, since it is often associated with bleeding complications or infectious diseases. Here, we report a case of life-threatening airway obstruction requiring ECMO. The trachea of the patient was narrowed by an anterior mediastinal tumor too highly to ventilate both lungs, so she had to be connected to venovenous-ECMO (VV-ECMO) before pathological examination and radical treatment were planned. During the intensive care with ECMO, she was diagnosed with malignant lymphoma and the chemotherapy was started. The chemotherapy brought such an immediate result that the trachea regained its patency and ECMO was disconnected 9 days after the initiation of the chemotherapy. Then, the patient was able to leave the intensive care unit with no sequelae. Central airway obstruction is a life-threatening situation, in which prompt decisions are essential. On the other hand, if the airway is impaired by hematological malignancy, it might be generally challenging to consider ECMO as a bridge until the chemotherapy takes an effect. The prognosis of hematological malignancy differs according to its subtype or stage, so it may be reasonable to take ECMO therapy into consideration for some population.

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