Acute respiratory distress syndrome (ARDS) treated successfully by veno-venous extracorporeal membrane oxygenation (ECMO) in a nearly drowned patient

Sonoo, Tomohiro; Ohshima, Kazuma; Kobayashi, Hiroaki; Asada, Toshifumi; Hiruma, Takahiro; Kento, Doi; Gunshin, Masataka; Murakawa, Tomohiro; Anraku, Masaki; Nakajima, Susumu; Nakajima, Jun; Yahagi, Naoki

doi:10.1007/s10047-014-0776-y

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…Among nontraumatic ARDS patients, the outcomes of the near‐drowning cases who suffered cardiac or pulmonary failure were good. Usually, near‐drowning events occur in otherwise healthy young subjects, and some authors have reported that ECMO support is useful even during the late phase of ARDS . Interestingly, one case of hanging was included in the nontraumatic group.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation Support in Trauma Versus Nontrauma Patients with Noninfectious Acute Respiratory Failure

Kim¹,

Ha²,

Han³

et al. 2016

Artificial Organs

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The utility of extracorporeal membrane oxygenation (ECMO) in patients with acute respiratory distress syndrome (ARDS) of noninfectious origin remains unclear. Data on patients with ARDS of noninfectious origin who underwent ECMO were reviewed retrospectively. We compared the pre-ECMO characteristics and hospital outcomes of patients with traumatic and nontraumatic ARDS. In total, 23 patients (trauma, n = 9; nontrauma, n = 14) were included in the study. The mean patient age was 42 years, there were three females, and the mean pre-ECMO Simplified Acute Physiologic Score (SAPS) II was 60.0 (49.0-71.0). The hemoglobin level was lower and the prothrombin time (PT) more prolonged, prior to initiation of ECMO, in traumatic compared with nontraumatic ARDS patients. During the first 48 h of ECMO support, the coagulation parameters did not differ between the two groups, but the platelet counts, PT, and activated partial thromboplastin time indicated that coagulopathy was developing in all patients. The hospital and 28-day mortality rates were 21.7 and 13.0%, respectively, and serious neurological outcomes (cerebral performance category [CPC] of three points or more) developed in 26.1% of all patients; however, the extent of such outcomes did not differ between traumatic and nontraumatic ARDS patients. Upon multivariate analysis, the pre-ECMO SAPS II tended to be associated with composite events (i.e., hospital death and/or a CPC of three points or more) (P = 0.051). Additionally, a history of hypertension and an elevated pre-ECMO SAPS II were significant risk factors for serious neurological outcomes among hospital survivors (n = 18). In conclusion, ECMO support can be associated with favorable outcomes in patients with ARDS of noninfectious origin, irrespective of whether the ARDS is associated with trauma. The pre-ECMO SAPS II and a history of hypertension may be independent risk factors for poor outcomes.

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Section: Discussionmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation Support in Trauma Versus Nontrauma Patients with Noninfectious Acute Respiratory Failure

Kim¹,

Ha²,

Han³

et al. 2016

Artificial Organs

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“…1a, d), suggesting that liver abscess might cause a diaphragmatic elevation, abnormal respiratory pattern and increased pulmonary vascular permeability on day 1. The use of ECMO to treat acute respiratory failure is increasing [8][9][10]. V-VECMO adult patients with sepsis-induced acute respiratory failure or pneumonia is not rare, while veno-arterial ECMO for adult patients with refractory septic shock is rare and remains unsatisfactory [11].…”

Section: Discussionmentioning

confidence: 99%

Veno-venous extracorporeal membrane oxygenation (ECMO) for acute respiratory failure caused by liver abscess

et al. 2014

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Liver abscess remains a life-threatening disease, particularly when it results in systemic organ failure necessitating intensive care. Only few cases of respiratory failure caused by liver abscess and treated with veno-venous extracorporeal membrane oxygenation (ECMO) have been reported. Here we present a case of liver abscess with rapid progression of multiple organ dysfunction, including severe acute respiratory failure on admission to the intensive care unit (ICU). Upon admission, we immediately initiated artificial organ support systems, including ventilator, continuous renal replacement therapy, and cardiovascular drug infusion for septic multiple organ failure and source control. Despite this initial management, respiratory failure deteriorated and V-V ECMO was introduced. The case developed abdominal compartment syndrome, for which we performed a bedside decompressive laparotomy in the ICU. The case gradually recovered from multiple organ failure and was discharged from the ICU on day 22 and from the hospital on day 53. Since liver abscess is potentially lethal and respiratory failure on admission is an additional risk factor of mortality, V-V ECMO may serve as an adjunctive choice of artificial organ support for cases of severe acute respiratory failure caused by liver abscess.

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“…Olguda öykünün derinleştirilmesiyle ilk yakınmasının fenalık hissi olduğu ve ardından bayıldığı, başına soğuk su dökülerek kendine geldiği sırada şiddetli nefes darlığı olduğu öğrenildiğinden ayırıcı tanıda düşünülmesi gereken bir diğer durum ise su aspirasyonuna sekonder solunum yetmezliği tablosudur. Literatürde, olgumuzda olduğu şekilde su aspirasyonu olan bir olguya rastlanmamış ancak, tatlı veya tuzlu su aspirasyonu sonucu gelişen ölümcül veya ölümcül olmayan boğulma olguları tanımlanmıştır (17)(18)(19). Ölümcül olmayan boğulma olgularında, aspire edilen suyun niteliğinden bağımsız olarak, alveolokapiller membranın bütünlüğünde bozulmaya ve artmış geçirgenliğe bağlı olarak gelişen pulmoner ödem, değişen derecelerde hipoksemiye ve hatta ARDS tablosuna yol açmaktadır (17,20).…”

Section: Olguunclassified

Sauna Kullanimi Sonrasi Geli̇şen Akut Solunum Yetmezli̇ği̇ Olgusu

Çakır

Evrimler

2020

SDÜ Tıp Fakültesi Dergisi

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Sauna kullanımı çeşitli akut ve geçici, kardiyovasküler ve hormonal değişikliklere neden olsa da çoğu sağlıklı erişkin ve çocuk tarafından iyi tolere edilir. Ancak, akut respiratuvar infeksiyon geçirenlerin sauna kullanmamaları önerilmektedir. Ayrıca, sempatomimetik ilaçlar saunada taşikardi ve aritmileri provoke edebilir. Sauna kullanımının kontrendikasyonları ise; stabil olmayan anjina pektoris, yakında geçirilen miyokard infarktüsü, ciddi aort stenozu, dekompanze kalp yetmezliği ve yaşlılarda görülen ciddi ortostatik hipotansiyondur. Sauna veya jakuzi kullanımına bağlı olarak günümüze değin bildirilen olgulardaki en yaygın akciğer patolojileri hipersensitivite pnömonitleridir. Sağlıklı, genç bir erişkin olan olgumuz, sauna kullanımı ve özellikle saunada mentol buharı soluma sonrasında bayılmış ve ardından akut solunum yetmezliği tablosunda acilen hastaneye yatırılmıştır. Başvurusunda çekilen toraks bilgisayarlı tomografisinde her iki akciğer parankiminde simetrik, diffüz, alt loblarda daha belirgin olmak üzere sentrilobüler konsantrasyon ve peribronkovasküler dağılım gösteren buzlu cam opasiteleri görülmüştür. Olguya antibiyotik, antiviral, steroid, mukolitik ilaçlar, intravenöz hidrasyon ve oksijen tedavileri uygulanmış ve hasta birkaç gün içinde taburcu edilmiştir. Taburcu olduktan beş gün sonra çekilen kontrol grafisi ve solunum fonksiyon testleri normal bulunan hasta, bu klinik ve radyolojik bulgulara neden olabilecek hastalıklar literatür eşliğinde tartışılarak sunulmuştur.

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Acute respiratory distress syndrome (ARDS) treated successfully by veno-venous extracorporeal membrane oxygenation (ECMO) in a nearly drowned patient

Cited by 6 publications

References 8 publications

Extracorporeal Membrane Oxygenation Support in Trauma Versus Nontrauma Patients with Noninfectious Acute Respiratory Failure

Extracorporeal Membrane Oxygenation Support in Trauma Versus Nontrauma Patients with Noninfectious Acute Respiratory Failure

Veno-venous extracorporeal membrane oxygenation (ECMO) for acute respiratory failure caused by liver abscess

Sauna Kullanimi Sonrasi Geli̇şen Akut Solunum Yetmezli̇ği̇ Olgusu

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