Veno-Venous Extra-Corporeal Membrane Oxygenation (ECMO) in a Child with Hemoptysis and Fontan Circulation
| Autor: | Gauthier Loron, Pierre Mauran, Francis Grossenbacher, Vito Giovanni Ruggieri, Anais Mons, Claude Marcus, Emre Belli, Nathalie Bednarek-Weirauch, Claudine Kumba, Jean-Marc Malinovsky |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Asphyxia
medicine.medical_specialty business.industry medicine.medical_treatment medicine.disease Collateral circulation Extracorporeal 03 medical and health sciences surgical procedures operative 0302 clinical medicine Respiratory failure 030225 pediatrics Internal medicine Life support Shock (circulatory) medicine Cardiology Extracorporeal membrane oxygenation 030212 general & internal medicine Tricuspid atresia medicine.symptom business |
| Zdroj: | Open Journal of Pediatrics. 10:280-287 |
| ISSN: | 2160-8776 2160-8741 |
| Popis: | Background: Extracorporeal membrane oxygenation is a rescue life support technique used in life threatening conditions of refractory respiratory and/or cardiac distress. Indication for extracorporeal life support in children depends on age and varies from pulmonary to cardiac pathologies. In some cases, it may be used as a bridge to a therapeutic procedure. We described here the management of respiratory failure due to hemoptysis in a child with a Fontan circulation and veno-venous extracorporeal membrane oxygenation which served as a bridge to angio-embolization. Hemoptysis can be a life threatening condition which can lead to hypovolemic shock and impaired alveolar gas exchange. The latter can result in respiratory failure and consequent asphyxia. When hemoptysis occurs in a patient with a univentricular heart and a Fontan circulation, management of this clinical situation can be challenging due to the particular physiology of the latter. Total cavopulmonary connection is a palliative surgical repair which constitutes Fontan circulation as a definitive treatment in patients with a univentricular heart. Methods: Case report description of a 16 year-old boy with a univentricular heart and a Fontan circulation who presented hemoptysis managed with a veno-venous extracorporeal membrane oxygenation (ECMO) as a bridge to angio-embolization. Results: Hemoptysis due to diffuse intra-alveolar hemorrhage from collateral circulation was successfully treated in this young patient with pulmonary vascular embolization. This allowed to wean the patient from extra-corporeal membrane oxygenation. Conclusion: Veno-venous ECMO can be life-saving as a bridge to angio-embolization for severe hemoptysis in patients with Fontan circulation. The reported case allows to underline that our multidisciplinary approach in this complex pediatric patient surely participated to improve outcome. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|