Veno-Arterial Extracorporeal Membrane Oxygenation for Septic Cardiomyopathy due to<i> Legionella </i>Pneumonia after Influenza Virus Infection

Asaki, Motohiro; Masuda, Tomoya; Miki, Yasuo

doi:10.1155/2018/6973197

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…Controversies surrounding the benefits of ECMO in septic shock with a predominantly vasoplegic phenotype persist 35). Favorable outcomes of VA ECMO in patients with septic shock combined with heart failures have been reported for recent years 36)37)38)39)…”

Section: Indications Of Venoarterial Extracorporeal Membrane Oxygenationmentioning

confidence: 99%

Clinical Pearls of Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock

2019

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Extracorporeal membrane oxygenation (ECMO) is a technique that uses a pump to drain blood from a body, circulate blood through a membrane lung, and return the oxygenated blood back into the body. Venoarterial (VA) ECMO is a simplified version of the heart-lung machine that assists native pulmonary and/or cardiac function. VA ECMO is composed of a drainage cannula in the venous system and a return cannula in the arterial system. Because VA ECMO can increase tissue perfusion by increasing the arterial blood flow, it is used to treat medically refractory cardiogenic shock or cardiac arrest. VA ECMO has a distinct physiology that is referred to as differential flows. It can cause several complications such as left ventricular distension with pulmonary edema, distal limb ischemia, bleeding, and thromboembolism. Physicians who are using this technology should be knowledgeable on the prevention and management of these complications. We review the basic physiology of VA ECMO, the mechanism of complications, and the simple management of VA ECMO.

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Section: Indications Of Venoarterial Extracorporeal Membrane Oxygenationmentioning

confidence: 99%

Clinical Pearls of Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock

2019

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“…Severe cardiogenic shock due to septic cardiomyopathy may improve with VA-ECMO use. 7,[11][12][13] Therefore, prompt VA-ECMO initiation should be considered for patients who have visited or lived in the tropics and present with signs of idiopathic cardiogenic shock.…”

Section: Leptospira Borgpetersenii Serovar Castellonismentioning

confidence: 99%

Case Report: An Imported Case of Severe Leptospirosis with Septic Cardiomyopathy Requiring Venoarterial Extracorporeal Membrane Oxygenation in Japan

Goto¹,

Oda²,

Norisue³

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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A 29-year-old Japanese man presenting with fever, joint pain, and diarrhea was admitted to the intensive care unit for cardiogenic and distributive shock. We suspected leptospirosis based on conjunctival hyperemia, skin rash, elevated bilirubin, and renal involvement; a travel history to Laos was also suggestive. We confirmed the diagnosis with blood and urine polymerase chain reaction and microscopic agglutination tests using paired serum samples. His hemodynamics were unstable, and his echocardiogram showed diffuse and severe left ventricular systolic dysfunction on day 2. He initially required venoarterial extracorporeal membrane oxygenation (V-A ECMO) support but responded and recovered on antimicrobial therapy. His cardiac function and hemodynamics improved on day 5. Severe leptospirosis may cause jaundice, renal failure, pulmonary hemorrhage, acute respiratory distress syndrome, and central nervous system involvement; however, few studies have reported severe cardiac manifestations. Herein, we report the first case of septic cardiomyopathy secondary to leptospirosis that was successfully managed with V-A ECMO. Leptospirosis should be included in the differential diagnosis when a patient returning from an endemic area presents with cardiogenic shock. Furthermore, intensive care management with prompt initiation of V-A ECMO should be considered to reverse septic cardiomyopathy.

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“… 72) Favorable outcomes of ECMO in patients with septic shock combined with heart failure have been reported in recent years. 73) 74) 75) 76) We suggest using ECMO only when there are significant signs of combined CS, such as high central venous pressure or pulmonary artery occlusion pressure. 29)…”

Section: Mechanical Circulatory Support Devicesmentioning

confidence: 99%

Mechanical Circulatory Support for Acute Heart Failure Complicated by Cardiogenic Shock

2020

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Acute heart failure is a potentially life-threatening condition that can lead to cardiogenic shock, which is associated with hypotension and organ failure. Although there have been many studies on the treatment for cardiogenic shock, early mortality remains high at 40-50%. No new medicines for cardiogenic shock have been developed. Recently, there has been a gradual decline in the use of the intra-aortic balloon pump mainly due to a lack of adequate hemodynamic support. Extracorporeal membrane oxygenation and the percutaneous ventricular assist device have become more widely used in recent years. A thorough understanding of the mechanisms of such mechanical support devices and their hemodynamic effects, components of the devices, implantation technique, management, criteria for indications or contraindications of use, and clinical outcomes as well as multidisciplinary decision making may improve the outcomes in patients experiencing cardiogenic shock.

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Veno-Arterial Extracorporeal Membrane Oxygenation for Septic Cardiomyopathy due to Legionella Pneumonia after Influenza Virus Infection

Cited by 3 publications

References 6 publications

Clinical Pearls of Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock

Clinical Pearls of Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock

Case Report: An Imported Case of Severe Leptospirosis with Septic Cardiomyopathy Requiring Venoarterial Extracorporeal Membrane Oxygenation in Japan

Mechanical Circulatory Support for Acute Heart Failure Complicated by Cardiogenic Shock

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