Amniotic fluid embolism‐induced cardiopulmonary collapse successfully treated with combination VA‐ECMO and Impella CP

Golzarian, Hafez; Mariam, Alaha; Shah, Sidra; Pasley, Benjamin; Haq, Syed H.; Edgerton, Anne R; Scherger, William E; Stallkamp, Vanessa L; Patel, Dennis; Laird, Amanda; Cole, William C.; Patel, Sandeep M.

doi:10.1002/ehf2.14254

Cited by 11 publications

(8 citation statements)

References 10 publications

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“…The case reports were extracted through a search of PubMed using the following search formula: "Embolism, Amniotic Fluid" (medical subject headings [MeSH]) AND "Extracorporeal Membrane Oxygenation" [MeSH]. As a result, 19 patients were identified from 19 case reports, [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] including the case report cited in the extracted article. [43,46] Cases in which VA-ECMO was used only in the operating room or venovenous ECMO was used, were excluded.…”

Section: Discussionmentioning

confidence: 99%

Amniotic fluid embolism rescued using venoarterial extracorporeal membrane oxygenation without initial anticoagulation: A case report and literature review

Araki,

Sekino,

Hasegawa

et al. 2024

Medicine

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Rationale: Amniotic fluid embolism (AFE) is a fatal obstetric condition that often rapidly leads to severe respiratory and circulatory failure. It is complicated by obstetric disseminated intravascular coagulation (DIC) with bleeding tendency; therefore, the introduction of venoarterial extracorporeal membrane oxygenation (VA-ECMO) is challenging. We report the case of a patient with AFE requiring massive blood transfusion, rescued using VA-ECMO without initial anticoagulation. Patient’s concerns: A 39-year-old pregnant patient was admitted with a complaint of abdominal pain. An emergency cesarean section was performed because a sudden decrease in fetal heart rate was detected in addition to DIC with hyperfibrinolysis. Intra- and post-operatively, the patient had a bleeding tendency and required massive blood transfusions. After surgery, the patient developed lethal respiratory and circulatory failure, and VA-ECMO was introduced. Diagnosis: Based on the course of the illness and imaging findings, the patient was diagnosed with AFE. Interventions: By controlling the bleeding tendency with a massive transfusion and tranexamic acid administration, using an antithrombotic ECMO circuit, and delaying the initiation of anticoagulation and anti-DIC medication until the bleeding tendency settled, the patient was managed safely on ECMO without complications. Outcomes: By day 5, both respiration and circulation were stable, and the patient was weaned off VA-ECMO. Mechanical ventilation was discontinued on day 6. Finally, she was discharged home without sequelae. Lessons: VA-ECMO may be effective to save the lives of patients who have AFE with lethal circulatory and respiratory failure. For safe management without bleeding complications, it is important to start VA-ECMO without initial anticoagulants and to administer anticoagulants and anti-DIC drugs after the bleeding tendency has resolved.

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Section: Discussionmentioning

confidence: 99%

Amniotic fluid embolism rescued using venoarterial extracorporeal membrane oxygenation without initial anticoagulation: A case report and literature review

Araki,

Sekino,

Hasegawa

et al. 2024

Medicine

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“…Case reports have described its use in perioperative arrest due to local anesthetic systemic toxicity, malignant hyperthermia, anaphylaxis, and amniotic fluid, fat, and pulmonary embolism. [43][44][45][46][47][48][49] A recent expert review on perioperative arrest indicates that extracorporeal CPR should be considered for cardiac arrest in the operating room and more specifically for arrest due to local anesthetic systemic toxicity, severe hyperkalemia, anaphylaxis, and pulmonary, gas, or fat embolism. 25,26 Extracorporeal CPR should also be considered for perioperative arrest due to cardiac arrhythmias, myocardial infarction, pulmonary hemorrhage, or loss of airway.…”

Section: Perioperative Indicationsmentioning

confidence: 99%

Perioperative Extracorporeal Cardiopulmonary Resuscitation in Adult Patients: A Review for the Perioperative Physician

Panda,

Glance,

Mazzeffi

et al. 2024

Anesthesiology

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“…Successful VA-ECMO use has been reported in amniotic fluid embolism cases. 62 , 63 Extracorporeal cardiopulmonary resuscitation indications in cancer patients are unclear, but understanding IHCA outcomes in this population is essential due to the incidence of cancer and improved survival rates. 64 Veno-arterial ECMO is a suitable treatment option for poisoning cases complicated by refractory cardiogenic shock or cardiac arrest, offering high survival rates with low complications.…”

Section: Indicationsmentioning

confidence: 99%

Is Extracorporeal Membrane Oxygenation a Panacea?

Karaoğlanoğlu,

Akgün

2024

The Eurasian Journal of Medicine

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Extracorporeal membrane oxygenation (ECMO) has emerged as a vital life-support technique in critical care medicine, providing temporary circulatory and/or respiratory support for patients with severe cardiac or respiratory failure unresponsive to conventional therapies. This review aims to outline the importance of ECMO and provide a comprehensive overview of its main applications. Two primary types of ECMO, veno-arterial extracorporeal membrane oxygenation and veno-venous extracorporeal membrane oxygenation, serve distinct functions in supporting patients with cardiac or pulmonary dysfunction, respectively. While ECMO offers life-saving potential, its utilization requires careful consideration due to its cost and resource-intensiveness. Thus, a comprehensive evaluation of an individual patient’s clinical condition, prognosis, and potential for recovery is crucial. Ongoing research and technological advancements continually refine ECMO techniques, enhance patient selection criteria, and improve long-term outcomes. Within this narrative review, we present an updated approach to patient selection and ECMO utilization, supported by a detailed literature review. By consolidating the current evidence, we aim to provide healthcare professionals with valuable insights into the ECMO’s post-pandemic role.

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Amniotic fluid embolism‐induced cardiopulmonary collapse successfully treated with combination VA‐ECMO and Impella CP

Cited by 11 publications

References 10 publications

Amniotic fluid embolism rescued using venoarterial extracorporeal membrane oxygenation without initial anticoagulation: A case report and literature review

Amniotic fluid embolism rescued using venoarterial extracorporeal membrane oxygenation without initial anticoagulation: A case report and literature review

Perioperative Extracorporeal Cardiopulmonary Resuscitation in Adult Patients: A Review for the Perioperative Physician

Is Extracorporeal Membrane Oxygenation a Panacea?

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