|
Author | Level of evidence | Reason to initiate ECMO | Respiratory settings recorded before ECMO | Advanced treatment modalities | Day of PH | Complications | Outcome |
|
Pardinas M et al [25] | Case report | Massive hemoptysis and acute hypoxemic respiratory failure (after 36 h of arrival) | Pao2/Fio2 ratio (P/F) <30 mm Hg and plateau pressures >40 cm/H2O, SpO2 74-80% (ACT –160-180 seconds due to persistent hemoptysis) | vv-ECMO (13 days), Aminocaproic acid infusion | D12 | Episodic hypotension, AKI on RRT, multiorgan failure | Discharged after 40 days |
|
Liao CY et al [26] | Case report | Refractory acute respiratory failure, severe hypercapnia, continuous bleeding from ET | Pao2/Fio2 ratio (P/F) – 163, pO2 of 65.5 mmHg and pCO2 of 78.1 mmHg and FiO2 of 40% | Venous ECMO (6 days) | D3 | No RRT (creatinine 1.6mg/dl), shock | Discharged after 10 days |
|
Umei N et al [27] | Case report | Pulmonary hemorrhage | FiO2 – 100%, paO2 - 70.4mmHg, paCO2 -28.3mmHg, PEEP - 10 cm H2O | vv-ECMO (11 days) | D5 | Septic shock, AKI on RRT, myocarditis | Recovered. Extubated on day 13 |
|
Arokianathan D et al [28] | Case report | Pulmonary hemorrhage with progressively decreasing oxygen saturations, 300 ml of fresh blood from endotracheal tube | FiO2 100%, paO2- 7.7kPa, pCO2 - 5.1kPa | vv-ECMO (183 hrs), molecular adsorption recycling system (MARS) for hyperbilirubinemia | D5 | AKI, hyperbilirubinemia, cardiac arrest | Recovery |
|
Cantwell T et al [29] | Case report | Pulmonary hemorrhage | PaO2/FiO2 - 89, Murray score 3 | vv-ECMO (8 days), high-volume hemofiltration (HVHF), high flow with 2 oxygenators (as the patient is obese) | | AKI, septic shock, ARDS, myocarditis | Discharged on day 28 |
|
Hery G et al [30] | Case report | Pulmonary hemorrhage with massive hemoptysis | PaO2: FiO2 ratio – 34, FiO2 100%, and PEEP of 10 cm H2O. | vv-ECMO (9 days) | | Shock, disseminated intravascular coagulation, AKI, lactic acidosis | Discharged after 20 days |
|
Kahn MJ et al [31] | Case report | Pulmonary hemorrhage with progressive hypoxia | | Venoarterial ECMO (60 hrs) | D3 | Septic shock, myocarditis, atrial fibrillation, AKI on RRT | Discharged on day 26 |
|
Ludwig et al [32] | Case report | Pulmonary hemorrhage | pO2 51.8 mmHg, pCO2 60.8mmHg, SpO2 60% on air | vv-ECMO, PEX, CRRT, extracorporeal cytokine absorbent therapy | D1 | AKI on RRT, septic shock, ARDS intravascular hemolysis (TTP DIC excluded) | Died 29 hrs after initial symptoms (17 hrs after admission) |
|
Delmas B et al [33] | Retrospective study of 134 ICU leptospirosis admissions | | Median Pao2/Fio2 ratio - 155 (85–211) for the 14 patients (10%) undergoing ventilation | | | Overall mortality rate was 6%, mortality in moderate-to-severe ARDS subgroup was 25%, four patients died from refractory ARDS (one with therapeutic limitations), three from multiple organ failure, and one from nosocomial septic shock | Five patients who underwent ECMO for refractory ARDS, 80% (4 patients) survived |
|