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Drug Des Devel Ther. 2013 Jul 24;7:627-33. doi: 10.2147/DDDT.S47156. Print 2013.

Successful application of extracorporeal membrane oxygenation due to pulmonary hemorrhage secondary to granulomatosis with polyangiitis.

Author information

1
II Medical Clinic, Coburg Clinic, University of Wuerzburg, Coburg, Germany.

Abstract

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.

KEYWORDS:

ARDS; ECMO; granulomatosis; hemorrhage; polyangiitis

PMID:
23926421
PMCID:
PMC3728271
DOI:
10.2147/DDDT.S47156
[Indexed for MEDLINE]
Free PMC Article

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