Dual veno-arterial extra-corporeal membrane oxygenation support in a patient with refractory hyperdynamic septic shock: a case report
| Autor: | Martin Balik, Michal Porizka, Michal Lips, Jan Rulisek, Michal Otahal, Marek Flaksa, Jan Belohlavek |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Cardiac output medicine.medical_treatment Shock Cardiogenic CIRCULATORY FAILURE Extracorporeal Membrane Oxygenation Refractory Internal medicine medicine Extracorporeal membrane oxygenation Humans Radiology Nuclear Medicine and imaging Advanced and Specialized Nursing business.industry Septic shock Hemodynamics General Medicine Oxygenation medicine.disease Shock Septic Hyperdynamic septic shock Hypodynamic septic shock surgical procedures operative Cardiology Cardiology and Cardiovascular Medicine business Safety Research |
| Zdroj: | Perfusion. 37:306-310 |
| ISSN: | 1477-111X 0267-6591 |
| Popis: | The hypodynamic septic shock appears to be a promising indication to veno-arterial membrane oxygenation (VA-ECMO) support of a patient with insufficient cardiac output. With cardiac recovery most of those patients progress into a hyperdynamic septic shock with cardiac output, which may not match critically low systemic vascular resistance to maintain perfusion pressures. Such refractory distributive shock represents a challenging indication to VA-ECMO. We report a rare case of a 27-year old patient who developed severe refractory hypodynamic septic shock due to the bilateral staphylococcal pneumonia and had to be initially rescued by femoro-femoral VA-ECMO. Despite extensive measures, he remained in intractable hypotension and profound tissue hypoperfusion with imminent multiorgan failure. The commencement of a second jugulo-axillary VA ECMO secured a total blood flow of 14.3 L/min, which restored perfusion pressure and successfully bridged patient over the period of critical haemodynamic instability and ultimately may have facilitated recovery. |
| Databáze: | OpenAIRE |
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