PMID- 32224696
OWN - NLM
STAT- MEDLINE
DCOM- 20201120
LR  - 20210310
IS  - 2575-3126 (Electronic)
IS  - 2575-3126 (Linking)
VI  - 14
IP  - 6
DP  - 2020 Apr
TI  - Dual RVAD-ECMO Circuits to Treat Cardiogenic Shock and Hypoxemia Due to 
      Necrotizing Lung Infection: A Case Report.
PG  - e01181
LID - 10.1213/XAA.0000000000001181 [doi]
AB  - Utilization of venoarterial extracorporeal membrane oxygenation (VA-ECMO) is 
      expanding, but dual VA-ECMO circuits to treat cardiogenic shock with refractory 
      hypoxemia is unreported. We describe the case of combined cardiogenic and 
      distributive shock due to necrotizing pulmonary blastomycosis. After initial 
      central VA-ECMO cannulation, acute respiratory distress syndrome (ARDS) with 
      increasing shunt resulted in significant central hypoxemia due to progressive 
      ventilation-perfusion mismatch. An additional circuit provided complete 
      oxygenation of the high circulating volume. After 4 months on support, he 
      underwent successful heart-lung-kidney transplantation. Dual ECMO circuits are 
      technically feasible and may be advantageous in specific circumstances of high 
      pulmonary shunting resulting in excessive hypoxemia unbalanced with appropriate 
      oxygen delivery.
FAU - Rosenbaum, Andrew N
AU  - Rosenbaum AN
AD  - From the Department of Cardiovascular Diseases.
FAU - Bohman, John K
AU  - Bohman JK
AD  - Department of Anesthesiology and Perioperative Medicine.
FAU - Rehfeldt, Kent H
AU  - Rehfeldt KH
AD  - Department of Anesthesiology and Perioperative Medicine.
FAU - Stulak, John M
AU  - Stulak JM
AD  - Department of Cardiovascular Surgery.
FAU - Daly, Richard C
AU  - Daly RC
AD  - Department of Cardiovascular Surgery.
FAU - Klompas, Allan M
AU  - Klompas AM
AD  - Department of Anesthesiology and Perioperative Medicine.
FAU - Behfar, Atta
AU  - Behfar A
AD  - From the Department of Cardiovascular Diseases.
AD  - William J. von Liebig Center for Transplantation and Clinical Regeneration.
AD  - VanCleve Cardiac Regenerative Medicine Program, Center for Regenerative Medicine, 
      Mayo Clinic, Rochester, Minnesota.
FAU - Yalamuri, Suraj M
AU  - Yalamuri SM
AD  - Department of Anesthesiology and Perioperative Medicine.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - A A Pract
JT  - A&A practice
JID - 101714112
RN  - 0 (liposomal amphotericin B)
RN  - 304NUG5GF4 (Itraconazole)
RN  - 7XU7A7DROE (Amphotericin B)
SB  - IM
MH  - Adult
MH  - Amphotericin B/therapeutic use
MH  - Extracorporeal Membrane Oxygenation/*methods
MH  - Fatal Outcome
MH  - Humans
MH  - Hypoxia/etiology/*therapy
MH  - Itraconazole/therapeutic use
MH  - Male
MH  - Pneumonia, Necrotizing/*complications/drug therapy
MH  - Shock, Cardiogenic/etiology/*therapy
EDAT- 2020/04/01 06:00
MHDA- 2020/11/21 06:00
CRDT- 2020/04/01 06:00
PHST- 2020/04/01 06:00 [entrez]
PHST- 2020/04/01 06:00 [pubmed]
PHST- 2020/11/21 06:00 [medline]
AID - 02054229-202004000-00016 [pii]
AID - 10.1213/XAA.0000000000001181 [doi]
PST - ppublish
SO  - A A Pract. 2020 Apr;14(6):e01181. doi: 10.1213/XAA.0000000000001181.