Extracorporeal membrane oxygenation in a patient with newly diagnosed acute myeloblastic leukaemia presenting with sever
- PDF / 585,837 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 7 Downloads / 167 Views
CASE REPORT Artificial Lung / ECMO
Extracorporeal membrane oxygenation in a patient with newly diagnosed acute myeloblastic leukaemia presenting with severe respiratory failure Manish Pandey1 · Marijke Peetermans1 · Andrew J. Doyle2 · Richard Dillon2 · Christopher I. S. Meadows1 Received: 26 September 2020 / Accepted: 28 October 2020 © The Japanese Society for Artificial Organs 2020
Abstract Veno-venous extracorporeal membrane oxygenation (ECMO) is typically instituted in severe respiratory failure, defined by Lung Injury Score, and caused either by pulmonary or extra-pulmonary reversible disease processes. These processes will have led to acute worsening of oxygenation and/or respiratory acidosis together with an inability to provide safe, lung protective, mechanical ventilation. Patients with underlying chronic immunosuppression or haematological malignancies treated with ECMO for severe respiratory failure have poor short- and long-term functional and survival outcomes. Consequently, in many centres, a diagnosis of haematological malignancy is considered a contraindication to provision of ECMO support for severe respiratory failure. We present a case of a 51-year-old female who attended her local hospital with symptoms suggestive of community-acquired pneumonia. Within a few days, there was progression to severe respiratory failure, initially managed with invasive mechanical ventilation but rapidly deteriorating respiratory failure triggered referral for ECMO support. Initial investigations on ECMO demonstrated features of acute myeloblastic leukaemia with a superimposed community-acquired pneumonia. This was successfully managed with supportive treatment alongside mechanical respiratory therapy and targeted chemotherapy, achieving complete remission and full functional recovery. Keywords Extracorporeal membrane oxygenation · Haematological malignancy · Acute myeloblastic leukaemia
Introduction We present the case of a 51-year-old female who presented to a local hospital with symptoms suggestive of community-acquired pneumonia. Within a few days, she rapidly progressed to having severe respiratory failure, which was initially managed with invasive mechanical ventilation but rapidly deteriorated requiring ECMO. Initial investigations showed features of acute myeloblastic leukaemia with a superimposed community-acquired pneumonia, which was successfully managed with supportive treatment along with
* Manish Pandey [email protected] 1
Department of Critical Care, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
Department of Haematology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
2
ECMO and chemotherapeutic drugs achieving complete remission and full functional recovery.
Case report A 51-year-old female active smoker with a medical history of metabolic syndrome and hypothyroidism presented initially to her GP and later to a local district general hospital with 3 days of dyspnoea. This was associated with a cough productive of brown expectoration, pleuritic chest pain, fever (
Data Loading...
