Extracorporeal membrane oxygenation resuscitation in adult patients with refractory septic shock

Sharma, Ajay S.; Weerwind, Patrick W.

doi:10.1016/j.jtcvs.2013.12.069

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…The role of ECMO in adults with septic shock is still controversial. [2][3][4] It is well known that ECMO does not filter circulating inflammatory cytokines that can worsen septic shock, [12] and thus, ECMO appears to have little effect in patients with predominantly distributive shock, where heart function is preserved but the increased oxygen demand itself cannot be overcome by ECMO support. [3] Recent studies suggest that ECMO may be beneficial in patients with severe myocardial injury, as it may provide extra time to overcome the hemodynamic instability caused by myocardial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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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“…Bleeding is one of the most common and serious complications of ECMO insofar as it is seen in about 8% to 20% of the cases. 3,10,18 Bleeding was the cause of death in 1 (9.1%) patient among all the unsuccessful ECMO patients. Multisystem organ failure was also seen in 7 (63.6%) of our patients, which was mostly due to a low flow state and the late application of ECMO.…”

Section: Easy Implantabilitymentioning

confidence: 99%

“…ECMO was introduced in 1972, since which time it has gradually become an accepted mode of treatment not only in a wide range of age, 1 from neonates to adults, but also in various reversible heart and lung diseases and irreversible heart and lung diseases as a bridge to transplantation 2 as well as in septic shock, 3 H1N1, 4 adult respiratory distress syndrome (ARDS), 5 and after cardiopulmonary resuscitation. 6 The main components of the ECMO circuit are the oxygenator and the pump.…”

Section: Introductionmentioning

confidence: 99%

First Experience with Extracorporeal Membrane Oxygenation in Iran, under Difficult Conditions

Ahmadi

Salehi

Niusha

et al. 2019

JTHC

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Background: Extracorporeal membrane oxygenation (ECMO) provides hemodynamic and oxygenation support in critical conditions. The commencement of this modality in Iran coincided with severe economic constraints across Iran. Methods: This retrospective study was performed in Masih Daneshvari Medical Center from 2010 to 2015, during which period, sanction-related limitations in the import of equipment prompted us to integrate a Medtronic or Stöckert head pump console into a Maquet ECMO Oxygenator so as to sustain the ECMO program. Comparisons were performed between successful and unsuccessful ECMO procedures and survivors. Factors associated with unsuccessful ECMO were evaluated with a multivariate logistic regression. Results: Thirty-three (68.8%) patients were male and 15 (31.2%) were female. The mean age of the patients was 35±16.6 years. Thirty-seven (77.1%) patients were weaned off ECMO successfully; the rate was higher than that in previous studies. Totally, 35.4% of the study population survived to hospital discharge. The most common cause of death in all the ECMO patients who were successfully weaned was sepsis. The most common cause of death in the patients who underwent unsuccessful ECMO was multisystem organ failure. The mean ECMO support time was 53.37±46.26 hours. The patients who were alive at discharge were significantly younger (25.5±14.5 vs. 40.2±15.5 y; P=0.002) and had a significantly lower ECMO duration (24 [25–75% interquartile: 18.5–36] vs. 48 [25–75% interquartile: 24–72] h; P=0.044) than the non-survivors. Conclusion: An assembly of ECMO components from different companies could be done safely, at least for a short period of time.

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Cardiac arrest with anaphylactic shock: a successful resuscitation using extracorporeal membrane oxygenation

Zhang

Liu

2015

The American Journal of Emergency Medicine

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Extracorporeal membrane oxygenation resuscitation in adult patients with refractory septic shock

Cited by 3 publications

References 5 publications

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

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

First Experience with Extracorporeal Membrane Oxygenation in Iran, under Difficult Conditions

Cardiac arrest with anaphylactic shock: a successful resuscitation using extracorporeal membrane oxygenation

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