Extracorporeal membrane oxygenation in Jehovah’s Witness patients: Case report, literature review, and summary of recommendations

Perfusion ◽  
2021 ◽  
pp. 026765912110477
Author(s):  
Abrahán Mera ◽  
Eduard Argudo ◽  
María Martínez-Martínez ◽  
Clara Palmada ◽  
Camilo Bonilla ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Influenza A ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Membrane Oxygenation ◽  
Influenza A H1n1 ◽  
Refractory Hypoxemia ◽  
Venovenous Ecmo ◽  
H1n1 Pneumonia ◽  
Witness Patient

Extracorporeal Membrane Oxygenation (ECMO) is commonly associated with a high blood transfusion requirement. Jehovah’s Witness patients present a particular challenge. The impossibility of transfusing blood cells and starting anticoagulation treatment are common contraindications for this supportive measure. Here we report the case of a Jehovah’s Witness patient with refractory hypoxemia due to influenza A H1N1 pneumonia who required venovenous ECMO for 11 days. We describe the use of a bloodless approach to reduce the waste of blood, avoiding anticoagulation, and improving red blood cell production. We then summarize the current literature on the use of ECMO in Jehovah’s Witness patients and, finally, we propose some recommendations for their management.

Transferring Patients With Refractory Hypoxemia to a Regional Extracorporeal Membrane Oxygenation Center

2014 ◽  
Vol 25 (4) ◽  
pp. 351-364 ◽  
Author(s):  
Christine S. Schulman ◽  
Christopher Bibro ◽  
Diane Braxmeyer Downey ◽  
Christine Lasich
Keyword(s):  
Health Care ◽  
Extracorporeal Membrane Oxygenation ◽  
Influenza A ◽  
Tissue Perfusion ◽  
Positive Outcomes ◽  
Health Care Teams ◽  
Membrane Oxygenation ◽  
Influenza A H1n1 ◽  
Refractory Hypoxemia ◽  
Ecmo Therapy

Because of technological advancements and encouraging experiences during the 2009 influenza A (H1N1) epidemic, many critical care clinicians consider extracorporeal membrane oxygenation (ECMO) a reasonable strategy for managing patients with refractory hypoxemia when standardized therapies have failed. Although the literature remains unclear as to whether it should be considered a routine or a rescue strategy in the management of patients with severe acute respiratory distress syndrome, experts agree that ECMO therapy is most likely to result in positive outcomes and fewer complications when provided at regional ECMO centers. Some institutions have developed the expertise and resources required to provide this sophisticated therapy, but significantly more facilities may choose to send their patients to a tertiary ECMO center when they do not respond to usual care. This article provides information essential for health care teams who refer their patients to such centers. The clinical indications for, and the use of, ECMO therapy in the management of refractory hypoxemia is briefly reviewed, followed by a description of how ECMO works to provide gas exchange and tissue perfusion. The primary considerations for circuit management, hemodynamic support, and pulmonary care are described, and significant complications of the therapy are identified. The remainder of the article focuses on the patient care and preparatory activities that occur before and during ECMO initiation, so that health care teams, patients, and their families can be confident of an efficient, safe, and highly skilled transfer of care between institutions.

scholarly journals The Evolution of the Use of Extracorporeal Membrane Oxygenation in Respiratory Failure

Membranes ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 491
Author(s):  
Danielle Feldhaus ◽  
Daniel Brodie ◽  
Philippe Lemaitre ◽  
Joshua Sonett ◽  
Cara Agerstrand
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Influenza A ◽  
Distress Syndrome ◽  
Rapid Expansion ◽  
Membrane Oxygenation ◽  
Influenza A H1n1 ◽  
Large Randomized Clinical Trial ◽  
Ventilator Management ◽  
Large Randomized Trial

Extracorporeal membrane oxygenation (ECMO) has been used with increasing frequency to support patients with acute respiratory failure, most commonly, and severe forms of acute respiratory distress syndrome (ARDS). The marked increase in the global use of ECMO followed the publication of a large randomized trial in 2009 and the experience garnered during the 2009 influenza A (H1N1) pandemic, and has been further supported by the release of a large, randomized clinical trial in 2018, confirming a benefit from using ECMO in patients with severe ARDS. Despite a rapid expansion of ECMO-related publications, optimal management of patients receiving ECMO, in terms of patient selection, ventilator management, anticoagulation, and transfusion strategies, is evolving. Most recently, ECMO is being utilized for an expanding variety of conditions, including for cases of severe pulmonary or cardiac failure from coronavirus disease 2019 (COVID-19). This review evaluates modern evidence for ECMO for respiratory failure and the current challenges in the field.

A child with influenza A (H1N1)-associated myocarditis rescued by extracorporeal membrane oxygenation

2010 ◽  
Vol 13 (4) ◽  
pp. 232-234 ◽  
Author(s):  
Takeshi Oda ◽  
Hiroshi Yasunaga ◽  
Yoshimitsu Tsutsumi ◽  
Takahiro Shojima ◽  
Yasuyuki Zaima ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Influenza A ◽  
Membrane Oxygenation ◽  
Influenza A H1n1

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.

scholarly journals Predicting mortality risk in patients undergoing venovenous ECMO for ARDS due to influenza A (H1N1) pneumonia: the ECMOnet score

2012 ◽  
Vol 39 (2) ◽  
pp. 275-281 ◽  
Author(s):  
Federico Pappalardo ◽  
◽  
Marina Pieri ◽  
Teresa Greco ◽  
Nicolò Patroniti ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Influenza A ◽  
Influenza A H1n1 ◽  
Venovenous Ecmo ◽  
H1n1 Pneumonia

scholarly journals Oxigenação extracorpórea por membrana na hipoxemia grave: hora de revermos nossos conceitos?

2012 ◽  
Vol 38 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Luciano Cesar Pontes Azevedo ◽  
Marcelo Park ◽  
Eduardo Leite Vieira Costa ◽  
Edzângela Vasconcelos Santos ◽  
Adriana Hirota ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Influenza A ◽  
Membrane Oxygenation ◽  
Influenza A H1n1

Em 2009, muitos casos de infecção pulmonar com hipoxemia grave refratária às estratégias ventilatórias habitualmente utilizadas e às manobras de resgate para a síndrome do desconforto respiratório agudo foram relatados durante a epidemia por influenza A (H1N1). Em muitos desses pacientes, o uso de extracorporeal membrane oxygenation (ECMO, oxigenação extracorpórea por membrana) foi necessário, fato que fez reacender o interesse na ECMO globalmente. O Grupo De Estudos em Suporte Extracorpóreo foi criado visando a aprender a técnica e a utilizar ECMO no tratamento de pacientes com hipoxemia grave. Neste artigo, são discutidas as indicações de ECMO e é relatado o caso de uma paciente com hipoxemia refratária que foi tratada através de ECMO de forma bem sucedida.

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