Adult ECMO patients with lower Hb(nadir) require more daily red blood cell and FFP. Hypertension increases daily FFP requirements. Recent antiplatelet agents, larger Hb decline and longer ECMO duration increase daily platelet requirements. Patients with sepsis or on ECMO for medical reasons have longer ECMO duration, which is associated with total transfusion requirements. Some of these factors may be identified early to optimize blood product support.

This study provides additional mortality information for the modern-day CCU and should help identify factors that may predict survival.

Human herpesvirus-6 (HHV-6) is a virus known for causing the highly contagious infection, roseola infantum, and has been associated with causing encephalitis in pediatric patients and less commonly in adult patients as well. Regardless of the patient's age, the primary HHV-6 infection could be complicated by neurological sequelae including encephalitis, acute encephalopathy with biphasic seizures syndrome, or demyelinating disease. HHV-6 encephalitis does occur in an adult as a primary infection or reactivation. However, immunocompromised, hematopoietic stem cell transplantation patients, and solid organ transplant recipients are the most affected population. Here we present a rare case of HHV-6 encephalitis in a 26-year-old healthy immunocompetent male. HHV-6 viral DNA was detected in the cerebrospinal fluid during the acute stage of the disease, and the diagnosis was confirmed by quantitative polymerase chain reaction (PCR). The patient was treated with ganciclovir and had a complete response to treatment without any further complication. The pathophysiology, clinical course, and treatment in otherwise immunocompetent adult patients are also discussed.

Lumbar punctures (LPs) are commonly performed procedures, serving diagnostic and therapeutic purposes. They are generally safe, and serious, life-threatening complications are rare. We report a case of a patient who underwent an LP and subsequently developed shock. Imaging studies revealed a retroperitoneal hematoma with an active bleed. Interrogation of the lumbar branches in the interventional radiology suite revealed an active arterial bleed at the level of L3-L4 which was successfully embolized. We present this case to highlight the possibility of a rare complication of an LP and to emphasize the importance of early detection and resuscitative intervention.

No abstract