The role of extracorporeal life support in the management with severe idiopathic pulmonary artery hypertension undergoing lung transplantation: are those patients referred too late?

We describe the case of a peripartum thrombotic thrombocytopenic purpura with fulminant cardiogenic shock treated with extracorporeal life support. Thrombotic thrombocytopenic purpura should be considered in the case of thrombotic microangiopathy with several or severe organ involvement and needs emergent treatment with plasmapheresis (with or without rituximab). In the case of cardiac involvement, aggressive treatment should be considered given the high mortality and the potential complete recovery.

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Reply to: The role of extracorporeal life support in patients with hypothermic cardiac arrest

Resuscitation ◽

10.1016/j.resuscitation.2018.10.027 ◽

2019 ◽

Vol 134 ◽

pp. 159-160

Author(s):

Michael M. Beyea ◽

Bourke W. Tillmann ◽

A. Dave Nagpal

Keyword(s):

Cardiac Arrest ◽

Life Support ◽

Extracorporeal Life Support

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Pulmonary artery hypertension in mitral stenosis: Role of right ventricular stroke volume, atrio-ventricular compliance, and pulmonary venous compliance

Journal of Anaesthesiology Clinical Pharmacology ◽

10.4103/0970-9185.94916 ◽

2012 ◽

Vol 28 (2) ◽

pp. 261 ◽

Cited By ~ 3

Author(s):

PraveenKumar Neema ◽

RameshChandra Rathod

Keyword(s):

Pulmonary Artery ◽

Stroke Volume ◽

Right Ventricular ◽

Mitral Stenosis ◽

Pulmonary Artery Hypertension ◽

Venous Compliance ◽

Ventricular Stroke Volume ◽

Ventricular Compliance ◽

Right Ventricular Stroke Volume

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Lung transplantation in pulmonary arterial hypertension

ESC CardioMed ◽

10.1093/med/9780198784906.003.0588 ◽

2018 ◽

pp. 2520-2524

Author(s):

Laurent Savale

Keyword(s):

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Lung Transplantation ◽

Medical Management ◽

Life Support ◽

Extracorporeal Life Support ◽

Right Heart Failure ◽

Optimal Timing ◽

Optimal Medical Management ◽

Pulmonary Arterial

Despite recent advances in medical management, lung and heart–lung transplantation remains an established treatment option in patients with end-stage pulmonary arterial hypertension (PAH) despite optimal medical therapy. The optimal timing of referral and listing patients for transplantation must take into consideration the co-morbidities, the aetiology of PAH, and the regular risk assessment based on a multidimensional approach. With the exception of PAH due to complex congenital heart disease, double-lung transplantation is the preferred option over combined heart–lung transplantation as cardiac function recovers after transplantation in most cases. The use of extracorporeal life support as a bridge to urgent transplantation may be considered in expert centres in selected patients with refractory right heart failure despite optimal medical management in an intensive care unit. With a survival rate at 5 years varying from 50% to 75%, transplantation in PAH can be considered as a life-saving procedure for patients with severe symptoms.

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Treatment of Polypharmacy Overdose with Multimodality Extracorporeal Life Support

Anaesthesia and Intensive Care ◽

10.1177/0310057x0503300118 ◽

2005 ◽

Vol 33 (1) ◽

pp. 120-123 ◽

Cited By ~ 24

Author(s):

G. Maclaren ◽

W. Butt ◽

P. Cameron ◽

A. Preovolos ◽

R. Mcegan ◽

...

Keyword(s):

Emergency Department ◽

Life Support ◽

Slow Release ◽

Extracorporeal Life Support ◽

Tertiary Referral ◽

Severe Metabolic Acidosis ◽

Verapamil Overdose ◽

Tertiary Referral Hospital ◽

Venoarterial Extracorporeal Membrane Oxygenation

A 45-year-old woman presented to the emergency department of a tertiary referral hospital after taking an overdose of verapamil, doxepin, quetiapine, diazepam, temazepam, and clonazepam. She rapidly developed shock refractory to pharmacological support and was placed on percutaneous venoarterial extracorporeal membrane oxygenation (ECMO). She had a severe metabolic acidosis from a combination of shock and drug intoxication that improved with continuous venovenous haemodialysis. Forty-eight hours after presentation, while still on ECMO, the patient had complete cardiac standstill for three and a half hours, attributable to slow-release verapamil, that resolved after the commencement of plasmapheresis. The role of plasmapheresis in verapamil overdose requires further study.

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The Role of Isoproterenol in Pulmonary Artery Hypertension of Unknown Etiology (Primary)

CHEST Journal ◽

10.1378/chest.79.3.292 ◽

1981 ◽

Vol 79 (3) ◽

pp. 292-296 ◽

Cited By ~ 24

Author(s):

Eulo Lupi-Herrera ◽

David Bialostozky ◽

Angel Sobrino

Keyword(s):

Pulmonary Artery ◽

Pulmonary Artery Hypertension ◽

Unknown Etiology

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Sex Differences in Right Ventricular-Vascular Coupling and Pulmonary Artery Impedance in Response to Chronic Hypoxia and Recovery

ASME 2012 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2012-80835 ◽

2012 ◽

Author(s):

Aiping Liu ◽

Lian Tian ◽

Diana M. Tabima ◽

Naomi C. Chesler

Keyword(s):

Pulmonary Artery ◽

Chronic Hypoxia ◽

Pulmonary Arteries ◽

Pulmonary Artery Hypertension ◽

Vascular Impedance ◽

Female Predominance ◽

Collagen Accumulation ◽

Dominant Disease ◽

Pulmonary Arterial

Pulmonary artery hypertension (PAH) is a female dominant disease (the female-to-male ratio is 4:1), characterized by small distal pulmonary arterial narrowing and large proximal arterial stiffening, which increase right ventricle (RV) afterload and ultimately lead to RV failure [1,2]. Our recent studies have shown that collagen accumulation induced by chronic hypoxia increases the stiffness of the large extralobar pulmonary arteries (PAs) [3], and affects pulmonary vascular impedance (PVZ) [4]. The role of collagen in the female predominance in developing PAH has not been explored to date.

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