title: Influenza A-induced cardiogenic shock requiring temporary ECMO support and urgent heart transplantation.
abstract: We report a case of a child with familial cardiomyopathy who contracted H1N1 influenza followed by cardiovascular collapse requiring immediate arteriovenous ECMO support. Despite the lack of experience with heart transplantation (HTx) soon after H1N1 infection, HTx was considered as an exit strategy since restoration of cardiac function was considered unlikely. In contrast to the most common indication for ECMO use in patients with H1N1 infection, early ECMO support in cases with infection-induced myocardial decompensation may be lifesaving. Additionally, this report shows that urgent heart transplantation in a patient on ECMO support can be performed safely after recent H1N1 infection and simultaneous heparin-induced thrombocytopenia, which has not been reported before. This case also indicates that H1N1 vaccination should be considered for potential transplantation candidates to prevent severe infection.
authors: Department of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine, Medical University of Vienna, Waehringer Guertel 18–20, Vienna, Austria.
authors: K
authors: K
authors: Skhirtladze
authors: D
authors: D
authors: Zimpfer
authors: A
authors: A
authors: Zuckermann
authors: M
authors: M
authors: Dworschak
mesh_terms: D000293:Adolescent; D000925:Anticoagulants / Q000009:adverse effects; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000601:surgery*; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D016027:Heart Transplantation; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D009980:Influenza A virus / Q000472:pathogenicity*; D007251:Influenza, Human / Q000150:complications* / Q000821:virology; D012770:Shock, Cardiogenic / Q000209:etiology / Q000601:surgery* / Q000821:virology; D013921:Thrombocytopenia / Q000139:chemically induced; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006493:Heparin