Experience with veno-venous ecmo in patients with adult respiratory distress syndrome secondary to viral pneumonia. Case series

  • Antonio Figueredo Cardiovascular Surgery Department, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.
  • Leonardo Salazar ECMO (Extracorporeal Membrane Oxygenation) and Artificial Heart Department, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.
  • Camilo E. Pizarro Intensive Care Department, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.
  • Mauricio Orozco-Levi Pulmonology Department, Hospital Internacional de Colombia, Piedecuesta, Colombia. http://orcid.org/0000-0002-3209-3462
  • Maria M. Botia Cardiovascular Surgery Department, Fundación Cardiovascular de Colombia, Floridablanca, Colombia. http://orcid.org/0000-0001-5522-6929
Keywords: Extracorporeal membrane oxygenation, H1N1, Adult respiratory distress syndrome, Viral pneumonia, Veno-venous

Abstract

Introduction: The use of extracorporeal membrane oxygenation (ECMO) has increased exponentially in recent years and has shown to be effective in treating adult respiratory distress syndrome (ARDS) secondary to H1N1-related pneumonia. However, evidence remains controversial. This study describes a case series of ECMO in ARDS secondary to viral pneumonia.

Methods: A search was conducted in the ECMO database of Fundación Cardiovascular de Colombia for the 2013-2017 period. A case series report was written of patients diagnosed with ARDS secondary to confirmed or suspected viral pneumonia.

Results: Nineteen patients with ECMO support and ARDS due to viral pneumonia were included in the study. The survival rate upon discharge was 11 patients (58%) and weaning from ECMO support was successful in 13 patients (68%). Hemorrhagic complications were the most frequent: gastrointestinal bleeding, 10 patients (53%); intracranial bleeding, 2 (10%); alveolar hemorrhage, 2 (10%);’ hemothorax requiring thoracostomy with chest tube drainage, 2 (10%); cannulation site bleeding, 9 patients (47%); and surgical site bleeding in 3 patients (25%) who required tracheostomy. Other complications were: pneumothorax, 1 patient (5%); sepsis, 6 patients (32%); and growth of microorganisms in bronchial lavage, 6 patients (32%).

Conclusions: This study supports the use of veno-venous ECMO to achieve a higher survival rate than expected in patients with severe ARDS and refractory hypoxemia secondary to viral pneumonia. Early initiation of the therapy should improve overall results.

References

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Patroniti N, Zangrillo A, Pappalardo F, Peris A, Cianchi G, Braschi A, et al. The Italian ECMO network experience during the 2009 influenza A(H1N1) pandemic: Preparation for severe respiratory emergency outbreaks. Intensive Care Med. 2011;37(9):1447–57. DOI: https://doi.org/10.1007/s00134-011-2301-6.

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How to Cite
1.
Figueredo A, Salazar L, Pizarro CE, Orozco-Levi M, Botia MM. Experience with veno-venous ecmo in patients with adult respiratory distress syndrome secondary to viral pneumonia. Case series. Colomb. j. anesthesiol. [Internet]. 2020Sep.7 [cited 2020Sep.27];48(4). Available from: https://www.revcolanest.com.co/index.php/rca/article/view/933

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Published
2020-09-07
How to Cite
1.
Figueredo A, Salazar L, Pizarro CE, Orozco-Levi M, Botia MM. Experience with veno-venous ecmo in patients with adult respiratory distress syndrome secondary to viral pneumonia. Case series. Colomb. j. anesthesiol. [Internet]. 2020Sep.7 [cited 2020Sep.27];48(4). Available from: https://www.revcolanest.com.co/index.php/rca/article/view/933
Section
Case Report / Case Series