A case of acute renal failure complicated with Takotsubo cardiomyopathy

Sugimoto, Toshiro; Deji, Naoko; Isono, Motohide; Kume, Shinji; Osawa, Norihisa; Kanasaki, Keizo; Araki, Shin‐ichi; Isshiki, Keiji; Kawazoe, T; Okada, Yusaku; Koya, Daisuke

doi:10.4009/jsdt.37.2093

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…[16] There are two case reports from Japan that suggest PMX-DHP may be beneficial in septic cardiomyopathy by absorbing inflammatory mediators. [17,18] There were no adverse events during the concurrent use of ECMO, CRRT, and hemofiltration in our case. We connected the hemofiltration device parallel to the CRRT device, which were then to the VA-ECMO circuit via three-wayconnectors.…”

Section: Discussionmentioning

confidence: 57%

Use of Polymyxin B Hemoperfusion in a Patient with Septic Shock and Septic Cardiomyopathy Who Was Placed on Extracorporeal Membrane Oxygen Support

Shin

Lee

Choi

et al. 2016

Korean J Crit Care Med

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Although shock in sepsis is usually managed successfully by conventional medical treatment, a subset of cases do not respond and may require salvage therapies such as veno-arterial extracorporeal membrane oxygenation (VA ECMO) support as well as an attempt to remove endotoxins. However, there are limited reports of attempts to remove endotoxins in patients with septic shock on VA ECMO support. We recently experienced a case of septic shock with severe myocardial injury whose hemodynamic improvement was unsatisfactory despite extracorporeal membrane oxygenation (ECMO) support. Since the cause of sepsis was acute pyelonephritis and blood cultures grew gram-negative bacilli, we additionally applied polymyxin B direct hemoperfusion (PMX-DHP) to the ECMO circuit and were able to successfully taper off vasopressors and wean off ECMO support. To the best of our knowledge, this is the first adult case in which PMX-DHP in addition to ECMO support was successfully utilized in a patient with septic shock. This case indicates that additional PMX-DHP therapy may be beneficial and technically feasible in patients with septic shock with severe myocardial injury refractory to ECMO support.

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Section: Discussionmentioning

confidence: 57%