Successful application of extracorporeal membrane oxygenation due to pulmonary hemorrhage secondary to granulomatosis with polyangiitis.
Extracorporeal membrane oxygenation (ECMO) is increasingly applied in adults with acute refractory respiratory failure that is deemed reversible. Bleeding is the most frequent complication during ECMO support. Severe pre-existing bleeding has been considered a contraindication to ECMO application. Nevertheless, there are cases of successful ECMO application in patients with multiple trauma and hemorrhagic shock or head trauma and intracranial hemorrhage. ECMO has proved to be life-saving in several cases of life-threatening respiratory failure associated with pulmonary hemorrhage of various causes, including granulomatosis with polyangiitis (Wegener's disease). We successfully applied ECMO in a 65-year-old woman with acute life-threatening respiratory failure due to diffuse massive pulmonary hemorrhage secondary to granulomatosis with polyangiitis, manifested as severe pulmonary-renal syndrome. ECMO sustained life and allowed disease control, together with plasmapheresis, cyclophosphamide, corticoids, and renal replacement therapy. The patient was successfully weaned from ECMO, extubated, and discharged home. She remains alive on dialysis at 17 months follow-up.
II Medical Clinic, Coburg Clinic, University of Wuerzburg, Coburg, Germany.
Wolfgang
W
Hohenforst-Schmidt
Arndt
A
Petermann
Aikaterini
A
Visouli
Paul
P
Zarogoulidis
Kaid
K
Darwiche
Ioanna
I
Kougioumtzi
Kosmas
K
Tsakiridis
Nikolaos
N
Machairiotis
Markus
M
Ketteler
Konstantinos
K
Zarogoulidis
Johannes
J
Brachmann
D000368:Aged; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006470:Hemorrhage / Q000150:complications; D006801:Humans; D008171:Lung Diseases / Q000150:complications*; D012131:Respiratory Insufficiency / Q000628:therapy*; D020293:Vasculitis, Central Nervous System / Q000150:complications*
ARDS; ECMO; granulomatosis; hemorrhage; polyangiitis