Successful therapy of severe pneumonia-associated ARDS after pneumonectomy with ECMO and steroids.
Pneumonia and acute respiratory distress syndrome are life-threatening complications after pneumonectomy carrying high mortality. Because pulmonary reserve is inadequately low, an effective therapeutic strategy is needed to treat hypoxia. Extracorporeal membrane oxygenation is a highly effective method to reverse hypoxia in patients with acute respiratory distress syndrome, but has only once been described in a patient with postpneumonectomy pulmonary edema. We report a case of successful extracorporeal membrane oxygenation therapy in a patient with pneumonia-associated acute respiratory distress syndrome after pneumonectomy. Methylprednisolone therapy caused a dramatic improvement of pulmonary and systemic organ function.
Dünser
Martin
M
Division of General and Surgical Intensive Care Medicine, Department of Anesthesia and Critical Care Medicine, Leopold-Franzens-University of Innsbruck, Innsbruck, Austria.
Hasibeder
Walter
W
Rieger
Michael
M
Mayr
Andreas J
AJ
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001983:Bronchial Fistula / Q000150:complications / Q000601:surgery / Q000628:therapy; D002283:Carcinoma, Bronchogenic / Q000601:surgery*; D015377:Cilastatin / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D015378:Imipenem / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D011013:Pneumonectomy; D011014:Pneumonia / Q000150:complications* / Q000188:drug therapy; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D012086:Reoperation; D012128:Respiratory Distress Syndrome / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*
D000893:Anti-Inflammatory Agents; D015377:Cilastatin; D002939:Ciprofloxacin; D015378:Imipenem; D008775:Methylprednisolone