title: Extracorporeal membrane oxygenation and severe acute respiratory distress secondary to Legionella: 10 year experience.
abstract: Legionella-associated respiratory failure has a high mortality, despite modern ventilation modalities. Extracorporeal membrane oxygenation (ECMO) is used to achieve gas exchange independent of pulmonary function in patients with severe respiratory failure. This was a retrospective review of the management and outcome of patients with Legionella-associated respiratory failure treated with ECMO support in a large ECMO center over the past 10 years. A retrospective review of patients with confirmed Legionella-associated severe respiratory failure managed with ECMO support at a single center. Between 2000 and 2010, 19 patients with severe respiratory failure caused by Legionella were managed with ECMO after failure to respond to conventional intensive care management. Median PaO2/FiO2 ratio was 66 and median pCO2 was 60 torr. Sixteen patients (84%) survived to hospital discharge. Extracorporeal membrane oxygenation should be considered in patients with Legionella-associated respiratory failure, who have failed conventional ventilation.
authors: Heartlink ECMO Centre, University Hospitals of Leicester NHS Trust, Leicester, UK. abinoah@doctors.org.uk
authors: Moronke A
authors: MA
authors: Noah
authors: Geethanjali
authors: G
authors: Ramachandra
authors: Margaret M
authors: MM
authors: Hickey
authors: David R
authors: DR
authors: Jenkins
authors: Chris J
authors: CJ
authors: Harvey
authors: Claire A
authors: CA
authors: Westrope
authors: Richard K
authors: RK
authors: Firmin
authors: Giles J
authors: GJ
authors: Peek
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007875:Legionella; D007876:Legionellosis / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000382:microbiology* / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome