Goodpasture's-Like Syndrome and Effect of Extracorporeal Membrane Oxygenator Support.

Daimon, Shoichiro; Umeda, Tomoya; Michishita, Ichiro Ichiro; Wakasugi, Harue; Genda, Akira; Koni, Ichiro

doi:10.2169/internalmedicine.33.569

Cited by 17 publications

(12 citation statements)

References 9 publications

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“…According to 2 case studies that administered nafamostat mesilate instead of heparin as an anticoagulant to treat pulmonary hemorrhage during ECMO use, Daimon et al (10) and Kotani et al (11) used a nafamostat mesilate infusion rate of 1.0 mg/kg/hr and 1.0-1.7 mg/kg/hr, and ACT was maintained at 150 sec in a 49-yr-old male patient and 190-200 sec in a 27-yr-old female patient, respectively. Nagaya et al (8) successfully treated bleeding complications in 12 neonates on ECMO by administering nafamostat mesilate at 0.48 mg/kg/hr and heparin at 21.0 U/kg/hr, while ACT was maintained at 205.7 sec.…”

Section: Discussionmentioning

confidence: 99%

Use of Nafamostat Mesilate as an Anticoagulant during Extracorporeal Membrane Oxygenation

Han

Kim

et al. 2011

J Korean Med Sci

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Although the incidence of bleeding complications during extracorporeal membrane oxygenator (ECMO) support has decreased in various trials, bleeding is still the most fatal complication. We investigated the ideal dosage and efficacy of nafamostat mesilate for use with ECMO in patients with acute cardiac or respiratory failure. We assessed 73 consecutive patients who received ECMO due to acute cardiac or respiratory failure between January 2006 and December 2009. To evaluate the efficacy of nafamostat mesilate, we divided the patients into 2 groups according to the anticoagulants used during ECMO support. All patients of nafamostat mesilate group were male with a mean age of 49.2 yr. Six, 3, 5, and 3 patients were diagnosed with acute myocardial infarction, cardiac arrest, septic shock, and acute respiratory distress syndrome, respectively. The mean dosage of nafamostat mesilate was 0.64 mg/kg/hr, and the mean duration of ECMO was 270.7 hr. The daily volume of transfused packed red blood cells, fresh frozen plasma, and cryoprecipitate and the number of complications related to hemorrhage and thrombosis was lower in the nafamostat mesilate group than in the heparin group. Nafamostat mesilate should be considered as an alternative anticoagulant to heparin to reduce bleeding complications during ECMO.

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Section: Discussionmentioning

confidence: 99%

Use of Nafamostat Mesilate as an Anticoagulant during Extracorporeal Membrane Oxygenation

Han

Kim

et al. 2011

J Korean Med Sci

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“…Initial improvement and weaning from ECMO has been reported in an adult patient with Goodpasture’s-like pulmonary-renal syndrome, who subsequently died after rebleeding 36. There are at least seven case reports of VV ECMO applied to adults with acute refractory respiratory failure secondary to Wegener’s granulomatosis, most of which had severe preexisting pulmonary hemorrhage 11,18–22,37…”

Section: Discussionmentioning

confidence: 99%

“…Nafamostat mesylate as anticoagulant is also rarely reported 31,36. Heparin infusion to maintain an ACT of 160–1804,5 or 130–150 seconds (instead of the institutional standard of 180–220) and a modified ECMO circuit with two oxygenators placed in parallel (one primed in-line to allow quick change in case of clotting)9 have been reported in pediatric patients with pulmonary hemorrhage due to GPA.…”

Section: Discussionmentioning

confidence: 99%

Successful application of extracorporeal membrane oxygenation due to pulmonary hemorrhage secondary to granulomatosis with polyangiitis

Hohenforst-Schmidt¹,

Petermann²,

Visouli³

et al. 2013

DDDT

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Extracorporeal membrane oxygenation (ECMO) is increasingly applied in adults with acute refractory respiratory failure that is deemed reversible. Bleeding is the most frequent complication during ECMO support. Severe pre-existing bleeding has been considered a contraindication to ECMO application. Nevertheless, there are cases of successful ECMO application in patients with multiple trauma and hemorrhagic shock or head trauma and intracranial hemorrhage. ECMO has proved to be life-saving in several cases of life-threatening respiratory failure associated with pulmonary hemorrhage of various causes, including granulomatosis with polyangiitis (Wegener’s disease). We successfully applied ECMO in a 65-year-old woman with acute life-threatening respiratory failure due to diffuse massive pulmonary hemorrhage secondary to granulomatosis with polyangiitis, manifested as severe pulmonary-renal syndrome. ECMO sustained life and allowed disease control, together with plasmapheresis, cyclophosphamide, corticoids, and renal replacement therapy. The patient was successfully weaned from ECMO, extubated, and discharged home. She remains alive on dialysis at 17 months follow-up.

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“…On the other hand, Daimon et al 15 reported a patient with pulmonary hemorrhage due to Goodpasture's-like syndrome who died of pulmonary rebleeding 17 h after ECMO disconnection. In this case, although oxygenation improved remarkably during ECMO support, the autopsy revealed that the lung was not reformed.…”

Section: Discussionmentioning

confidence: 99%

Clinical Results of Extracorporeal Membrane Oxygenation (ECMO) Support for Acute Respiratory Failure: A Comparison of a Centrifugal Pump ECMO with a Roller Pump ECMO

et al. 2004

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Goodpasture's-Like Syndrome and Effect of Extracorporeal Membrane Oxygenator Support.

Cited by 17 publications

References 9 publications

Use of Nafamostat Mesilate as an Anticoagulant during Extracorporeal Membrane Oxygenation

Use of Nafamostat Mesilate as an Anticoagulant during Extracorporeal Membrane Oxygenation

Successful application of extracorporeal membrane oxygenation due to pulmonary hemorrhage secondary to granulomatosis with polyangiitis

Clinical Results of Extracorporeal Membrane Oxygenation (ECMO) Support for Acute Respiratory Failure: A Comparison of a Centrifugal Pump ECMO with a Roller Pump ECMO

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