Pediatric Extracorporeal Cardiopulmonary Resuscitation Patient With Traumatic Subarachnoid Hemorrhage and Takotsubo Syndrome

Pearson, Thomas E.; Frizzola, Meg; Priest, Marc; Rochman, Monica F.; Froehlich, Curtis D

doi:10.1016/j.amj.2017.09.002

Cited by 9 publications

(7 citation statements)

References 11 publications

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“…Through the literature search, 614 articles were found in Pubmed, 488 in Medline, 869 in Embase, and 5 by searching the references in publications included in the analysis (Figure 1). The following subgroups were created based on the bleeding conditions: 1 patient with tracheal injury, 13 11 patients with postpartum or cesarean delivery hemorrhage, 14–19 7 patients with intracranial hemorrhage, 20–25 53 patients with pulmonary hemorrhage, 5,26–66 13 patients with postpulmonary endarterectomy bleeding, 67–72 and 96 patients with bleeding trauma 51,73–96 (Table 1; see Supplementary Tables 1–5, Supplemental Digital Content, http://links.lww.com/ASAIO/A515). Overall, 183 patients were identified in 86 included publications, namely, 74 case reports, 4 case series, 7 retrospective database observational studies, and 1 preliminary results of ongoing study.…”

Section: Resultsmentioning

confidence: 99%

“…The heparin-free period varied between 4 hours and 2 days in 12 patients. 5,22,33,39,51,65,75,84 Re-start of anticoagulation was performed after damage control surgery, detection of clots in the circuit, or control of the bleeding site. 23,26,41,46,53,56,74,84,94,96 In seven patients, the heparin-free time was not specified 15,71,91 (Supplemental Figure 2, Supplemental Digital Content, http://links.lww.com/ASAIO/A515).…”

Section: Resultsmentioning

confidence: 99%

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Extracorporeal Life Support in Hemorrhagic Conditions: A Systematic Review

et al. 2020

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Extracorporeal Life Support in Hemorrhagic Conditions: A Systematic Review

et al. 2020

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“…Sympathetic dysregulation and subsequent catecholamine excess supposedly cause direct toxic cardiomyocyte damage as well as coronary spasms in face of higher cardiac workload (5,16,17). Neurological and neurosurgical disorders as causes of Takotsubo cardiomyopathy seem less common in children than in adult patients (6) and include intracerebral hemorrhage, in some cases due to AVMs and fistulas (7,(18)(19)(20)(21)(22). Like in our case, especially lesions affecting the medulla, home to important regulators of the autonomic function, can furthermore cause dysregulation of blood pressure and heart rate due to baroreflex failure resulting in cardiogenic shock (17,23,24).…”

Section: Discussionmentioning

confidence: 99%

Takotsubo cardiomyopathy in a 12-year-old boy caused by acute brainstem bleeding—a case report

Thomas¹,

Johler²,

Hermann³

et al. 2021

Transl Pediatr

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Takotsubo cardiomyopathy is characterized by acute and reversible severe left ventricular dysfunction due to intensive emotional or physical stress followed by catecholamine excess. Traditionally it is most common in postmenopausal women, whereas only few cases have been described in childhood.In our case a previously well 12-year-old boy presented with severe cardiogenic shock due to dramatically impaired left ventricular function requiring significant inotropic support and invasive mechanical ventilation.Interestingly, cardiac catheterization, myocardial tissue histology and biochemical laboratory tests did not yield a definitive diagnosis. As his cardiac function improved gradually within several days and deep sedation could be weaned, he was then found to suffer from hemiparesis and absence of protective airway reflexes on neurological examination during the weaning process. Subsequent brain imaging studies revealed a brainstem bleeding due to a fistulous arteriovenous malformation (AVM) appearing to be only a few days old. After endovascular coiling and subsequent microsurgical resection of the malformation, he recovered completely.Our present case demonstrated, that brainstem bleeding could precipitate Takotsubo cardiomyopathy manifesting hemodynamic collapse. Severe ventricular impairment has been described in many adults with subarachnoid hemorrhage; however, this condition is extremely rare among children. When severe cardiogenic shock is diagnosed, precipitating factors such as intracranial processes should be ruled out on a regular basis.

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“…5,6 Rarely ECMO is needed for recovery of these patients. 7,8 But there are to the best of our knowledge there are no reports of this condition causing death despite ECMO support. Authors report a case of stress-induced cardiomyopathy that developed after a total colectomy who suffered unfavorable outcome even with the use of ECMO.…”

Section: Introductionmentioning

confidence: 99%

A case of stress induced cardiomyopathy with extracorporeal membrane oxygenation after total colectomy

et al. 2019

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Takotsubo cardiomyopathy or stress-induced cardiomyopathy is a cardiac syndrome of a reversible, transient left ventricular dysfunction that is caused by emotional and/or physical stress and surgery. Its clinical manifestations are similar to acute myocardial ischemia in absence of coronary artery lesion. It is more common in middle-aged women, and the prognosis is favourable. We report the case of a 32-year-old male patient who underwent a total colectomy, developed stress-induced cardiomyopathy and had poor outcome despite extracorporeal membrane oxygenation (ECMO).

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Pediatric Extracorporeal Cardiopulmonary Resuscitation Patient With Traumatic Subarachnoid Hemorrhage and Takotsubo Syndrome

Cited by 9 publications

References 11 publications

Extracorporeal Life Support in Hemorrhagic Conditions: A Systematic Review

Extracorporeal Life Support in Hemorrhagic Conditions: A Systematic Review

Takotsubo cardiomyopathy in a 12-year-old boy caused by acute brainstem bleeding—a case report

A case of stress induced cardiomyopathy with extracorporeal membrane oxygenation after total colectomy

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