Extracorporeal membrane oxygenation to rescue profound pulmonary hemorrhage due to idiopathic pulmonary hemosiderosis in a child.
Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of diffuse alveolar hemorrhage (DAH) in pediatric patients. During the acute phase, death due to massive alveolar hemorrhage and subsequent severe respiratory failure with associated multiple organ failure often occurs. We report the case of an 11-year-old girl who developed severe hypoxemic respiratory failure and pulmonary hemorrhage. Extracorporeal membrane oxygenation (ECMO) was instituted on the next day because medical treatment and mechanical ventilation failed to maintain oxygenation. She was successfully decannulated 5 days later without ECMO-related complications. Four months later, she was intubated again and the diagnosis of IPH was made by open lung biopsy. She was treated with systemic steroid therapy and discharged smoothly. We suggest that ECMO provides a chance of recovery and survival for patients with IPH, even if accompanied by severe pulmonary hemorrhage.
Sun
Li-Chuan
LC
Department of Pediatrics, Cardinal Tien Hospital, Taipei, Taiwan.
Tseng
Yu-Ru
YR
Huang
Shu-Chien
SC
Huang
Pei-Ming
PM
Ko
Wen-Je
WJ
Lu
Frank Leigh
FL
Wu
En-Ting
ET
D002648:Child; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006486:Hemosiderosis / Q000150:complications*; D006801:Humans; D008171:Lung Diseases / Q000150:complications*; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000628:therapy*