title: [Extracorporeal membrane oxygenation and plasmapheresis in the treatment of severe pulmonary hemorrhage secondary to nodose polyarteritis].
abstract: We report to simultaneous use of extracorporeal life support (ECLS), plasmapheresis, hemodiafiltration and exogenous surfactant for the treatment of pulmonary hemorrhage, arterial hypertension, and renal failure secondary to nodose polyarteritis (NPA) in a 23-month-old patient. NPA is an autoimmune disease that affects small -and medium- caliber muscular arteries. Hypoxemia refractory to treatment with conventional and high frequency oscillatory ventilation was supported by ECMO while awaiting control of the autoimmune disease through the use of plasmapheresis and immunosuppressive treatment. Although the combination of ECLS with plasmapheresis is rare, it has been described during the management of cases of organ transplant, intoxication, cardiac failure, and sepsis. There are only two previous reports describing the use of this combined therapy for the treatment of pulmonary hemorrhage secondary to autoimmune vasculitis in childhood.
authors.affiliation: Hospital Universitario Austral, Pilar. rkeller@cas.austral.edu.ar
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Keller
authors.forename: Silvio
authors.initials: S
authors.lastname: Torres
authors.forename: Thomas
authors.initials: T
authors.lastname: Iölster
authors.forename: Christian
authors.initials: C
authors.lastname: Kreutzer
authors.forename: Rafael
authors.initials: R
authors.lastname: Fraire
authors.forename: Magdalena
authors.initials: M
authors.lastname: Grassi
authors.forename: Damián
authors.initials: D
authors.lastname: Arrese
authors.forename: Omar
authors.initials: O
authors.lastname: Trabadelo
authors.forename: Manuel
authors.initials: M
authors.lastname: Rocca Rivarola
mesh_terms: D003131:Combined Modality Therapy / Q000379:methods; D015199:Extracorporeal Membrane Oxygenation; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000209:etiology / Q000628:therapy*; D008297:Male; D010956:Plasmapheresis; D010488:Polyarteritis Nodosa / Q000150:complications*