Cardiogenic shock with highly complicated course after influenza A virus infection treated with vva-ECMO and Impella CP (ECMELLA): a case report
| Autor: | Michael Bucher, Angelos G. Rigopoulos, Daniel Ebert, Michel Noutsias, Alexander Mensch, Jan Willsch, Markus Stiller, Artur Rebelo, Elke Weber, Richard Ibe, Henning Baust, Lorenz Homeister, Nils Mungard, Joerg Ukkat |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Myocarditis Critical Care Shock Cardiogenic Cardiomyopathy Impella Severity of Illness Index Ventricular Dysfunction Left Extracorporeal Membrane Oxygenation Recovery Mechanical circulatory support Internal medicine Influenza Human Case report Severity of illness medicine Humans Diseases of the circulatory (Cardiovascular) system Serologic Tests Cardiogenic shock Heart Failure Clinical Deterioration SARS-CoV-2 business.industry COVID-19 medicine.disease Respiration Artificial Cardiac surgery Respiratory acidosis Treatment Outcome Echocardiography Influenza A virus RC666-701 Cardiology Female Heart-Assist Devices ECMO medicine.symptom Respiratory Insufficiency Cardiology and Cardiovascular Medicine business Hypercapnia |
| Zdroj: | BMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-7 (2021) BMC Cardiovascular Disorders |
| ISSN: | 1471-2261 |
| Popis: | Background The value of mechanical circulatory support (MCS) in cardiogenic shock, especially the combination of the ECMELLA approach (Impella combined with ECMO), remains controversial. Case presentation A previously healthy 33-year-old female patient was submitted to a local emergency department with a flu-like infection and febrile temperatures up to 39 °C. The patient was tested positive for type-A influenza, however negative for SARS-CoV-2. Despite escalated invasive ventilation, refractory hypercapnia (paCO2: 22 kPa) with severe respiratory acidosis (pH: 6.9) and a rising norepinephrine rate occurred within a few hours. Due to a Horovitz-Index Conclusions This exceptional case exemplifies the importance of aggressive MCS in severe cardiogenic shock, which may be especially promising in younger patients with non-ischaemic cardiomyopathy and potentially reversible causes of cardiogenic shock. This case impressively demonstrates that especially young patients may achieve complete neurological restoration, even though the initial prognosis may appear unfavourable. |
| Databáze: | OpenAIRE |
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