title: A case series of the successful use of ECMO, continuous renal replacement therapy, and plasma exchange for thrombocytopenia-associated multiple organ failure.
abstract: We present three cases of pediatric patients with thrombocytopenia-associated multiple organ failure and the evidence for providing extracorporeal organ support. All three patients had severe cardiac dysfunction, respiratory failure, and acute kidney injury treated with venoarterial extracorporeal membrane oxygenation, continuous renal replacement therapy, and plasma exchange. Despite the presence of multiple organ failure and high risk of mortality, all three patients survived with minimal long-term sequelae.
authors.affiliation: Division of Pediatric Critical Care, Vanderbilt University School of Medicine, ECMO Medical, Doctor's Office Tower 5109, Nashville, TN 37232-9075, USA. brian.c.bridges@vanderbilt.edu
authors.forename: Brian C
authors.initials: BC
authors.lastname: Bridges
authors.forename: Daphne
authors.initials: D
authors.lastname: Hardison
authors.forename: John
authors.initials: J
authors.lastname: Pietsch
mesh_terms: D051722:ADAM Proteins / Q000172:deficiency; D000071120:ADAMTS13 Protein; D000293:Adolescent; D016470:Bacteremia / Q000150:complications / Q000382:microbiology; D016887:Cardiopulmonary Resuscitation; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D015199:Extracorporeal Membrane Oxygenation; D005440:Fluid Therapy / Q000009:adverse effects; D006323:Heart Arrest; D006440:Hemofiltration; D006463:Hemolytic-Uremic Syndrome / Q000097:blood / Q000150:complications; D006612:High-Frequency Ventilation; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000209:etiology / Q000534:rehabilitation; D009980:Influenza A virus; D007251:Influenza, Human / Q000150:complications; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D009102:Multiple Organ Failure / Q000097:blood / Q000150:complications / Q000628:therapy*; D010019:Osteomyelitis / Q000150:complications / Q000382:microbiology; D010951:Plasma Exchange; D013203:Staphylococcal Infections / Q000150:complications / Q000382:microbiology; D057049:Thrombotic Microangiopathies / Q000209:etiology / Q000628:therapy*; D014139:Tracheostomy
chemical_list: D002317:Cardiovascular Agents; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human