Mycoplasma Pneumonia as Cause of Acute Respiratory Distress Syndrome (ARDS) and Diffuse Alveolar Hemorrhage (DAH) Requiring Veno-Venous Extra Corporeal Membrane Oxygenation (VV-ECMO)

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 163A
Author(s):  
Killol Patel ◽  
Nadeem Ali ◽  
Habib Nazir ◽  
Rashid Mamoona ◽  
Muneera Naeem ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Extra Corporeal Membrane Oxygenation ◽  
Membrane Oxygenation ◽  
Mycoplasma Pneumonia ◽  
Vv Ecmo

scholarly journals Early veno-venous Extra Corporeal Membrane Oxygenation with prone positioning in the treatment of severe Acute Respiratory Distress syndrome in a pediatric patient: a case report

2019 ◽  
Vol 6 (4) ◽  
pp. 1743
Author(s):  
Md Nawad Azam ◽  
Senthil Kumar S. P.
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Adult Population ◽  
Age Group ◽  
Prone Positioning ◽  
Extra Corporeal Membrane Oxygenation ◽  
Membrane Oxygenation ◽  
Vv Ecmo

Aim of the study was to discuss effectiveness and outcome of Extra Corporeal Membrane Oxygenation (ECMO) therapy with prone positioning while on ECMO in a child with severe Acute Respiratory Distress Syndrome (ARDS). Veno-venous ECMO (VV-ECMO) and prone position on ECMO are relatively newer modalities of treatment in severe ARDS in pediatric age group and to our experience very few cases has been reported in paediatric age group. A 5 year old male child presented with fever with respiratory distress. He deteriorated in next 48 hrs leading to severe hypoxemia with ARDS following which he was put on conventional ventilation. In view of worsening critical lung parameters, veno-venous ECMO was initiated. Child had persistent hypoxemia inspite on high positive end expiaratory pressure (PEEP), adequate flow and adequate Post oxygenator PO2. Recirculation and other possible causes were excluded. Prone positioning (PP) was done for 8 hrs a day with chest physiotherapy while on ECMO. Patient showed considerable improvement in next few days and ECMO was weaned on day 7 and child was discharged on day 16 with good lung recovery. Although studies on VV-ECMO with PP has proven effectiveness in severe ARDS in adult population, overall studies in paediatric ARDS are very limited. Prone positioning on ECMO may decrease duration of ECMO support. Prone positioning on VV ECMO is safe and can be considered in Persistent hypoxemia with poor respiratory compliance.

Does acute kidney injury affect survival in adults with acute respiratory distress syndrome requiring extracorporeal membrane oxygenation?

Perfusion ◽  
2018 ◽  
Vol 33 (5) ◽  
pp. 375-382 ◽  
Author(s):  
Richard Devasagayaraj ◽  
Nicholas C. Cavarocchi ◽  
Hitoshi Hirose
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Kidney Injury ◽  
Membrane Oxygenation ◽  
Vv Ecmo

Introduction: Patients who develop severe acute respiratory distress syndrome (ARDS) despite full medical management may require veno-venous extracorporeal membrane oxygenation (VV ECMO) to support respiratory function. Survival outcomes remain unclear in those who develop acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) during VV ECMO for isolated severe respiratory failure in adult populations. Methods: A retrospective chart review (2010-2016) of patients who underwent VV ECMO for ARDS was conducted with university institutional review board (IRB) approval. Patients supported by veno-arterial ECMO were excluded. AKI was defined by acute renal failure receiving CRRT and the outcomes of patients on VV ECMO were compared between the AKI and non-AKI groups. Results: We identified 54 ARDS patients supported by VV ECMO (mean ECMO days 12 ± 6.7) with 16 (30%) in the AKI group and 38 (70%) in the non-AKI group. No patient had previous renal failure and the serum creatinine was not significantly different between the two groups at the time of ECMO initiation. The AKI group showed a greater incidence of complications during ECMO, including liver failure (38% vs. 5%, p=0.002) and hemorrhage (94% vs. 45%, p=0.0008). ECMO survival of the AKI group (56% [9/16]) was inferior to the non-AKI group (87% [33/38], p=0.014). Conclusions: Our study demonstrated that VV ECMO successfully manages patients with severe isolated lung injury. However, once patients develop AKI during VV ECMO, they are likely to further develop multi-organ dysfunction, including hepatic and hematological complications, leading to inferior survival.

Long term veno-venous extracorporeal life support without intravenous anticoagulation for diffuse alveolar hemorrhage

Perfusion ◽  
2019 ◽  
Vol 34 (6) ◽  
pp. 523-525 ◽  
Author(s):  
Samuel M Galvagno ◽  
Nirav G Shah ◽  
Christopher R Cornachione ◽  
Kristopher B Deatrick ◽  
Michael A Mazzeffi ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Systemic Anticoagulation

Introduction: Diffuse alveolar damage is the histologic hallmark for the acute phase of acute respiratory distress syndrome and can occasionally present as diffuse alveolar hemorrhage. Case report: We report a patient with diffuse alveolar hemorrhage and acute respiratory distress syndrome requiring veno-venous extracorporeal life support for 210 days, who was successfully treated for a period of 130 consecutive days without intravenous anticoagulation. Discussion: Although there are a few brief reports detailing long extracorporeal life support runs, the literature is largely devoid of data regarding long-term extracorporeal life support without full systemic anticoagulation. Regular inspection of the extracorporeal membrane oxygenation circuit is critical because externally visible thrombi may predict internal thrombus generation with the potential for systemic embolization or abrupt oxygenator failure. In our case, multiple circuit and oxygenators changes were required. Conclusion: We have demonstrated that a patient with a contraindication for systemic anticoagulation can safely have veno-venous extracorporeal life support for prolonged periods without catastrophic thrombotic complications.

Does Earlier Cannulation With Veno-Venous Extracorporeal Membrane Oxygenation in Adult Patients With Acute Respiratory Distress Syndrome Decrease Duration of Artificial Mechanical Ventilation?

2020 ◽  
Vol 13 (2) ◽  
pp. 148-155
Author(s):  
Christine Hartner ◽  
Jacqueline Ochsenreither ◽  
Kenneth Miller ◽  
Michael Weiss
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Adult Patients ◽  
Membrane Oxygenation ◽  
Vv Ecmo

BackgroundAcute respiratory distress syndrome (ARDS) is characterized by an acute, diffuse, inflammatory lung injury, leading to increased alveolar capillary permeability, increased lung weight, and loss of aerated lung tissue (Fan, Brodie, & Slutsky, 2018). Primary treatment for ARDS is artificial mechanical ventilation (AMV) (Wu, Huang, Wu, Wang, & Lin, 2016). Given recent advances in technology, the use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) to treat severe ARDS is growing rapidly (Combes et al., 2014).ObjectiveThis 49-month quantitative, retrospective inpatient EMR chart review compared if cannulation with VV-ECMO up to and including 48 hours of admission and diagnosis in adult patients 30 to 65 years of age diagnosed with ARDS, decreased duration on AMV, as compared to participants who were cannulated after 48 hours of admission and diagnosis with ARDS.MethodsA total of 110 participants were identified as receiving VV-ECMO during the study timeframe. Of the 58 participants who met all inclusion criteria, 39 participants were cannulated for VV-ECMO within 48 hours of admission and diagnosis with ARDS, and 19 participants were cannulated with VV-ECMO after 48 hours of admission and diagnosis with ARDS.ResultsData collected identified no statistically significant (p < 0.579) difference in length of days on AMV between participant groups.ConclusionsFurther studies are needed to determine if earlier initiation of VV-ECMO in adult patients with ARDS decrease time on AMV.Implications for NursingAlthough the results related to length of time on AMV did not produce statistical significance, the decreased duration of AMV in the participants who were cannulated within 48 hours (21 days vs. 27 days) may support several benefits associated with this participant population including increased knowledge of healthcare providers, decreased lung injury, earlier discharge which decreases hospital and patient cost, ability for patients to communicate sooner, decreased risk of pulmonary infection, decreased length of stay, decreased cost, and improved patient and family satisfaction.

Diffuse alveolar hemorrhage with acute respiratory distress syndrome associated with phenprocoumon therapy

2008 ◽  
Vol 19 (8) ◽  
pp. 813-815 ◽  
Author(s):  
Anne F Klenner ◽  
Sigrun Friesecke ◽  
Christoph Schäper ◽  
Ralf Ewert ◽  
Sven Gläser
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage

Successful use of Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricular support for acute respiratory distress syndrome in an adolescent with complex congenital heart disease

Perfusion ◽  
2020 ◽  
pp. 026765912092388
Author(s):  
Niranjan Vijayakumar ◽  
Aditya Badheka ◽  
Madhuradhar Chegondi ◽  
Daniel Mclennan
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Left Ventricular ◽  
Extra Corporeal Membrane Oxygenation ◽  
Assist Device ◽  
Ventricular Assist ◽  
Membrane Oxygenation ◽  
Left Ventricular Assist

Rescuing patients with the development of acute respiratory distress syndrome and right heart failure after left ventricular assist device placement remains a challenge in patients with congenital heart disease. TandemLife Protek Duo (TandemLife, Pittsburg, PA) is a double-lumen cannula introduced via the internal jugular vein that can provide veno-venous extra-corporeal membrane oxygenation and right heart support. To our knowledge, we report the first case of successfully using the TandemLife Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricle support in an adolescent male with an existing right ventricle-pulmonary artery conduit and the melody pulmonary valve who developed severe acute respiratory distress syndrome after the placement of left ventricular assist device. The stability of the cannula enabled minimal recirculation-related hypoxia events, early mobilization, and ambulation. Our patient was discharged home after lung recovery and currently awaiting a heart transplant.

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