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Perfusion. 2014 Jan;29(1):39-43. doi: 10.1177/0267659113497229. Epub 2013 Jul 17.

Extracorporeal life support for acute respiratory distress syndrome due to severe Legionella pneumonia.

Author information

1
1Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.

Abstract

PURPOSE:

Legionella is a common cause of community-acquired pneumonia (CAP) and is second only to Pneumococcal pneumonia as a cause of severe CAP that requires treatment in an intensive care unit. We report a case series of patients with severe Legionella pneumonia who developed the acute respiratory distress syndrome (ARDS), failed to improve with mechanical ventilation alone and required extracorporeal life support (ECLS).

METHODS:

We performed a retrospective study of all patients treated with ECLS at our institution for severe ARDS as a result of Legionella pneumonia from 1994 to 2006.

RESULTS:

A total of twelve patients with a diagnosis of Legionella pneumonia were treated with veno-venous (VV) ECLS over this time period. Nine of these twelve (75%) were successfully treated and weaned off ECLS and 8 patients (67%) survived to hospital discharge. Two (13%) died of multisystem organ failure, one patient (8%) died from global hypoxic encephalopathy and one (8%) was weaned from ECLS, but ultimately died of liver failure. Renal failure requiring some form of continuous dialysis occurred in seven patients (58%) and the survival for this sub-set of patients was 43%.

CONCLUSIONS:

Extracorporeal life support for severe ARDS associated with Legionella pneumonia is an effective treatment option when mechanical ventilation fails, especially when introduced early in the course.

KEYWORDS:

acute respiratory distress syndrome; extracorporeal life support; extracorporeal membrane oxygenation; legionellosis; pneumonia; respiratory failure

PMID:
23863490
PMCID:
PMC6464119
DOI:
10.1177/0267659113497229
[Indexed for MEDLINE]
Free PMC Article

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