Venoarterial Extracorporeal Membrane Oxygenation Support Rescue of Obstructive Shock Caused by Bulky Compressive Mediastinal Cancer

Bourcier, Simon; Villié, Patricia; Nguyen, Stéphanie; Hékimian, Guillaume; Demondion, Pierre; Bréchot, Nicolas; Luyt, Charles‐Édouard; Lebreton, Guillaume; Schmidt, Matthieu

doi:10.1164/rccm.202001-0193le

Cited by 4 publications

(1 citation statement)

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“…They had different degrees of obstructive shock when they entered the ICU. After emergency VA-ECMO support, they were diagnosed with cancer and received chemotherapy ( 10 ). With respect to pediatrics, Ward reported three successful instances of planned VV-ECMO to bridge surgery in infants with airway obstruction caused by airway tumors.…”

Section: Discussionmentioning

confidence: 99%

Successful Use of Extracorporeal Life Support and Continuous Renal Replacement Therapy in the Treatment of Cardiogenic Shock Induced by Tumor Lysis Syndrome in a Pediatric Patient With Lymphoma: A Case Report

et al. 2022

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The use of extracorporeal membrane oxygenation (ECMO) in the treatment of cardiopulmonary failure in children with malignant tumors is controversial. There are few reports on the use of ECMO in the treatment of children with tumor lysis syndrome. This article reports a case of a 9-year-old girl who presented with hyperkalemia and cardiogenic shock. The discovery of an abdominal mass with critical ultrasound provided key evidence for the initial diagnosis of tumor lysis syndrome. Cardiopulmonary resuscitation was performed for 1 h. Veno-arterial ECMO was installed at the bedside to provide cardiopulmonary support for the patient and was combined with continuous renal replacement therapy (CRRT) to improve her internal environment. The patient was ultimately diagnosed with mature B-cell lymphoma with tumor lysis syndrome. A severe electrolyte disorder led to cardiogenic shock. After the electrolyte imbalance was corrected, the patient's heart function gradually improved, ECMO was successfully weaned, and chemotherapy was continued with the support of CRRT. One month after ECMO weaning, the organ function of the patient had recovered and there were no serious complications. In this case report, we paid attention to the rapid diagnosis of the etiology behind a patient's shock with critical ultrasound as well as the initiation and management of extracorporeal cardiopulmonary resuscitation (ECPR), which provided us with valuable experience using VA-ECMO on critically ill children with tumors. It is also important evidence for the use of ECMO in the treatment of children with cardiopulmonary arrest secondary to malignancy.

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Section: Discussionmentioning

confidence: 99%