Extracorporeal membrane oxygenation in life-threatening ANCA-positive diffuse necrotizing alveolar hemorrhage

Nephrology ◽  
2018 ◽  
Vol 3_2018 ◽  
pp. 57-62
Author(s):  
M.A. Lysenko Lysenko ◽  
N.F. Frolova Frolova ◽  
M.V. Ketskalo Ketskalo ◽  
E.N. Dyakova Dyakova ◽  
I.L. Sysoeva Sysoeva ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Alveolar Hemorrhage ◽  
Membrane Oxygenation ◽  
Life Threatening

scholarly journals Successful management of warfarin-exacerbated diffuse alveolar hemorrhage using an extracorporeal membrane oxygenation

2013 ◽  
Vol 8 ◽  
Author(s):  
Jong Hoo Lee ◽  
Su Wan Kim
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Warfarin Therapy ◽  
Ventilatory Support ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Vein Thrombosis ◽  
Membrane Oxygenation ◽  
Threatening Condition ◽  
Life Threatening ◽  
Chest X Ray

Although diffuse alveolar hemorrhage complicating warfarin therapy is rare, it generally has a worsening clinical course and can be a life threatening condition. A 56-year-old male who had undergone a pulmonary lobectomy for lung cancer 2 years before had received warfarin for about 5 months due to pulmonary vein thrombosis. The patient presented with severe dyspnea and had prolonged anticoagulation values. Chest X-ray and computed tomography revealed diffuse pulmonary consolidations, and bronchoalveolar lavage demonstrated diffuse alveolar hemorrhage. The reversal of anticoagulation was initiated, and extracorporeal membrane oxygenation was performed for refractory respiratory failure that did not improve despite maximal mechanical ventilatory support. The diffuse alveolar infiltrations resolved after 5 days, and we successfully weaned off both extracorporeal membrane oxygenation and mechanical ventilation. Herein we report the detailed course of a case that was successfully treated with extracorporeal membrane oxygenation as a bridge-to-recovery for warfarin- exacerbated diffuse alveolar hemorrhage.

scholarly journals Extracorporeal Membrane Oxygenation for Diffuse Alveolar Hemorrhage Caused by Idiopathic Pulmonary Hemosiderosis: A Case Report and a Review of the Literature

2019 ◽  
Vol 08 (03) ◽  
pp. 181-186 ◽  
Author(s):  
Shotaro Matsumoto ◽  
Satoshi Nakagawa
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Rescue Therapy ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Membrane Oxygenation ◽  
Pulmonary Hemosiderosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Systemic Anticoagulation ◽  
Idiopathic Pulmonary Hemosiderosis

AbstractDiffuse alveolar hemorrhage (DAH) is a life-threatening condition presenting with hemoptysis, anemia, and diffuse radiographic pulmonary infiltrates; it causes acute respiratory failure. Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of DAH occurring predominantly in children. Bleeding is often considered to be a contraindication for extracorporeal membrane oxygenation (ECMO) due to systemic anticoagulation. We present an 8-year-old girl with DAH caused by IPH. Unfractionated heparin was administered to maintain an activated clotting time of 150 to 180 seconds. The DAH resolved with immunosuppressive therapy, and the patient survived to decannulation. ECMO may be applied as a rescue therapy for DAH even with systemic anticoagulation.

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.

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