Dual RVAD-ECMO Circuits to Treat Cardiogenic Shock and Hypoxemia Due to Necrotizing Lung Infection: A Case Report

Andrew N. Rosenbaum, John K. Bohman, Kent H. Rehfeldt, John M. Stulak, Richard C Daly, Allan M. Klompas, Atta Behfar, Suraj M. Yalamuri

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Utilization of venoarterial extracorporeal membrane oxygenation (VA-ECMO) is expanding, but dual VA-ECMO circuits to treat cardiogenic shock with refractory hypoxemia is unreported. We describe the case of combined cardiogenic and distributive shock due to necrotizing pulmonary blastomycosis. After initial central VA-ECMO cannulation, acute respiratory distress syndrome (ARDS) with increasing shunt resulted in significant central hypoxemia due to progressive ventilation-perfusion mismatch. An additional circuit provided complete oxygenation of the high circulating volume. After 4 months on support, he underwent successful heart-lung-kidney transplantation. Dual ECMO circuits are technically feasible and may be advantageous in specific circumstances of high pulmonary shunting resulting in excessive hypoxemia unbalanced with appropriate oxygen delivery.

Original languageEnglish (US)
Pages (from-to)e01181
JournalA&A practice
Volume14
Issue number6
DOIs
StatePublished - Apr 1 2020

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Dual RVAD-ECMO Circuits to Treat Cardiogenic Shock and Hypoxemia Due to Necrotizing Lung Infection: A Case Report'. Together they form a unique fingerprint.

Cite this