Salvage extracorporeal membrane oxygenation in induction-associated acute respiratory distress syndrome in acute leukemia patients: A case series

Huprikar, Nikhil; Peterson, Matthew R.; DellaVolpe, Jeffrey; Sams, Valerie G.; Lantry, James; Walter, Robert; Osswald, Michael B.; Chung, Kevin K.; Mason, Phillip E.

doi:10.1177/0391398818799160

Cited by 11 publications

(4 citation statements)

References 21 publications

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“…A few studies have been published on outcomes of ECMO in patients with malignant diseases. According to recent studies, the median overall survival rate was still low in adult patients with hematologic malignancies who developed ARDS receiving ECMO ( 9 , 10 , 15 ). More recently, the largest study reported the outcome of 297 adult patients with cancer with severe ARDS, and the 60-day survival rate was 26.8% (95% CI 22.1–32.4%).…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome in children with leukemia/lymphoma: A retrospective case series

et al. 2022

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ObjectiveThe cancer patients with severe acute respiratory distress syndrome (ARDS) benefit from extracorporeal membrane oxygenation (ECMO) remains unanswered. We analyzed clinical characteristics and outcomes of pediatric patients with leukemia/lymphoma who developed ARDS and treated with ECMO.MethodsPediatric leukemia or lymphoma patients with ARDS who underwent ECMO between August 2017 and December 2021 were retrospectively analyzed in a tertiary pediatric intensive care unit (PICU).ResultsSeven patients with median age 53 (IQR 42–117) months and 4 males were included. Six cases of leukemia [5 of acute lymphocytic leukemia (ALL) and 1 of acute myelogenous leukemia (AML, M5)] and 1 of non-Hodgkin lymphoma with severe ARDS received ECMO on chemotherapy period. The etiology of ARDS is community or chemotherapy-associated bacterial or/and fungal or viral infection. All the patients received chemotherapy in the 2 weeks prior to ECMO and five were neutropenic at initial ECMO. Six cases underwent veno-arterial ECMO (VA ECMO) and 1 for veno-venous ECMO (VV-ECMO). The median duration of ECMO support was 122 (IQR 56–166) hours. Overall, 42.9% (three of seven) survived to hospital discharge and 6 months survival rate was 28.6% (two of seven). Bleeding was the main ECMO-associated complication occurring in 7 patients, followed by nosocomial infection in 4 cases. All the patients required vasopressor support, and 6 received continuous renal replacement therapy (CRRT).ConclusionOur experiences suggest that rescue ECMO provides a selective treatment strategy in childhood hematologic malignancies with severe ARDS.

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Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome in children with leukemia/lymphoma: A retrospective case series

et al. 2022

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“…ECMO can provide cardiac and pulmonary support in critically ill patients with cardiogenic shock or acute respiratory failure[ 5 ]. The use of ECMO in cancer patients who develop severe acute respiratory distress syndrome (ARDS) remains controversial[ 6 ]. However, several studies have reported the successful use of ECMO in patients who develop respiratory failure after chemotherapy for hematologic malignancies[ 3 , 4 , 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…The use of ECMO in cancer patients who develop severe acute respiratory distress syndrome (ARDS) remains controversial[ 6 ]. However, several studies have reported the successful use of ECMO in patients who develop respiratory failure after chemotherapy for hematologic malignancies[ 3 , 4 , 6 , 7 ]. Chung et al [ 8 ] reported that under ECMO support, the patient underwent bronchial stent implantation and was successfully weaned off ECMO.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation for lung cancer-related life-threatening hypoxia: A case report

Yoo¹,

Lee²,

Choi³

2022

WJCC

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BACKGROUND Life-threatening hypoxia can occur in patients with lung cancer due to bronchial obstruction. Extracorporeal membrane oxygenation (ECMO) can be used as a bridge therapy for patients with severe hypoxia not relieved by conventional mechanical treatment. However, the usefulness of chemotherapy in patients with lung cancer receiving ECMO therapy is not well known. CASE SUMMARY A 53-year-old man visited the emergency room with worsening dyspnea for 1 mo. A series of imaging and diagnostic tests were performed, and stage IIIB (cT4N2M0) lung cancer was eventually diagnosed. On hospital day 3, he experienced dyspnea and hypoxia that was not relieved with oxygen support via a high-flow nasal cannula. ECMO was initiated because his respiratory condition did not improve even with mechanical ventilation. The patient then underwent gemcitabine/cisplatin chemotherapy without dose reduction while on ECMO. After two cycles of chemotherapy, there was a decrease in the size of the primary tumor in the right main bronchus. After the completion of concurrent chemoradiotherapy, a computed tomography scan revealed further improvement in the right main bronchus narrowing. Eight months after a lung cancer diagnosis, the patient did well without any dyspnea. CONCLUSION ECMO is a potential bridge therapy for respiratory failure in patients with central airway obstruction secondary to lung cancer.

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“…Venovenous extracorporeal membrane oxygenation (VV ECMO) is a mechanical-assisted therapy for the extracorporeal gas exchange in patients with severe respiratory failure, which oxygenates and removes carbon dioxide from the blood [ 8 , 9 ]. VV ECMO has been reported as successful in limited case studies for acute pneumonia with hematologic malignancies, including in S. maltophilia hemorrhagic pneumonia associated with hematologic malignancies [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal membrane oxygenation in Stenotrophomonas maltophilia pneumonia during acute myeloid leukemia: A case report

Saito

Aokage

Sato

et al. 2020

Respiratory Medicine Case Reports

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Stenotrophomonas maltophilia ( S. maltophilia ) is a Gram-negative, multidrug-resistant organism that both opportunistically infects the bloodstream and leads to pneumonia in immunosuppressed patients, including those with hematologic malignancies. In patients with severe respiratory failure, venovenous extracorporeal membrane oxygenation (VV ECMO) can stabilize the respiratory status. However, whether ECMO in patients with hematologic malignancies improves the clinical outcomes is still controversial because ECMO increases the risk of the exacerbation of sepsis and bleeding. We report a case of a 46-year-old man with Stenotrophomonas maltophilia hemorrhagic pneumonia acquired during consolidation chemotherapy for acute myeloid leukemia in whom VV ECMO lead to a good clinical outcome. The stabilization of his respiratory status achieved with VV ECMO allowed time for trimethoprim-sulfamethoxazole antibiotic therapy to improve the pneumonia. We suggest the background of patients, including comorbidities and general conditions, should be taken into account when considering the clinical indications of ECMO.

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Salvage extracorporeal membrane oxygenation in induction-associated acute respiratory distress syndrome in acute leukemia patients: A case series

Cited by 11 publications

References 21 publications

Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome in children with leukemia/lymphoma: A retrospective case series

Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome in children with leukemia/lymphoma: A retrospective case series

Extracorporeal membrane oxygenation for lung cancer-related life-threatening hypoxia: A case report

Extracorporeal membrane oxygenation in Stenotrophomonas maltophilia pneumonia during acute myeloid leukemia: A case report

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