title: Successful use of extracorporeal membrane oxygenation in an adult patient with toxic shock-induced heart failure.
abstract: Cardiomyopathy secondary to toxic shock syndrome (TSS) is an uncommon but potentially life-threatening problem. We report the case of a 51-year-old male who presented with profound cardiogenic shock and multiorgan failure that could not be managed by conventional therapy with intravenous fluids, vasopressors and inotropes. Venoarterial extracorporeal membrane oxygenation (VA ECMO) was instituted as a bridge to recovery. After administration of antibiotics and intravenous immunoglobulin, the patient's condition improved and he was successfully weaned off ECMO after 6 days. The patient recovered from multiorgan failure, and left ventricular ejection fraction improved from <10% pre-ECMO to 65% 8 months after discharge. This case supports the view that VA ECMO can be used successfully to support vital organ perfusion in patients with profound but reversible cardiomyopathy attributed to TSS.
authors.affiliation: Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Eilon
authors.initials: E
authors.lastname: Gabel
authors.affiliation: Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA vgudzenko@mednet.ucla.edu.
authors.forename: Vadim
authors.initials: V
authors.lastname: Gudzenko
authors.affiliation: Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Cruz
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Abbas
authors.initials: A
authors.lastname: Ardehali
authors.affiliation: Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Mitchell P
authors.initials: MP
authors.lastname: Fink
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D015199:Extracorporeal Membrane Oxygenation; D005122:Exudates and Transudates / Q000382:microbiology; D006439:Hemodynamics; D006801:Humans; D007362:Intensive Care Units; D007871:Leg Ulcer / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy; D012121:Respiration, Artificial; D012770:Shock, Cardiogenic / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy; D012772:Shock, Septic / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy; D013207:Staphylococcal Skin Infections / Q000276:immunology / Q000382:microbiology*; D013290:Streptococcal Infections / Q000276:immunology / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: ECMO; cardiomyopathy; heart failure; sepsis; toxic shock syndrome