Septic shock is a systemic severe disease with high morbidity and mortality. Hemodynamic and respiratory failure need supportive management, while early antibiotics administration and control of the sources of infection are crucial for patient outcome. Complications of sepsis include acute respiratory distress syndrome and multiple organ dysfunctions. We report our successful use of venous–venous extracorporeal membrane oxygenation in a patient who developed severe septic shock, complicated by multiple organ dysfunction. A 36-year-old woman was admitted to the Intensive Care Unit for severe respiratory distress, acute kidney injury, following septic shock caused by H1N1 influenza, methicillin-resistant S. aureus and M. catarrhalis infections. Antimicrobials, fluid replacement, continuous renal replacement therapy, protective mechanical ventilation, and venous–venous extracorporeal membrane oxygenation were performed. Cardiac arrest occurred due to tension pneumothorax and cardiac tamponade. Because of septic thrombosis, amputation of the 4 limbs was necessary. The course was complicated by bronchopleural fistula requiring placement of bronchial blockers followed by right inferior lobectomy. The patient successfully recovered and discharged. In septic shock complicated by multiorgan failure, supportive therapies should be targeted to maintain whole body’s functions. Extracorporeal membrane oxygenation represents a possible option for severe acute respiratory distress syndrome caused by sepsis.

The Use of Venous–Venous Extracorporeal Membrane Oxygenation in a Patient with Severe Acute Respiratory Distress Syndrome and Multiple Organ Failure Due to Septic Shock: A Case Report

Ferraioli S.;Marchese F.;Pelosi P.;Battaglini D.
2023-01-01

Abstract

Septic shock is a systemic severe disease with high morbidity and mortality. Hemodynamic and respiratory failure need supportive management, while early antibiotics administration and control of the sources of infection are crucial for patient outcome. Complications of sepsis include acute respiratory distress syndrome and multiple organ dysfunctions. We report our successful use of venous–venous extracorporeal membrane oxygenation in a patient who developed severe septic shock, complicated by multiple organ dysfunction. A 36-year-old woman was admitted to the Intensive Care Unit for severe respiratory distress, acute kidney injury, following septic shock caused by H1N1 influenza, methicillin-resistant S. aureus and M. catarrhalis infections. Antimicrobials, fluid replacement, continuous renal replacement therapy, protective mechanical ventilation, and venous–venous extracorporeal membrane oxygenation were performed. Cardiac arrest occurred due to tension pneumothorax and cardiac tamponade. Because of septic thrombosis, amputation of the 4 limbs was necessary. The course was complicated by bronchopleural fistula requiring placement of bronchial blockers followed by right inferior lobectomy. The patient successfully recovered and discharged. In septic shock complicated by multiorgan failure, supportive therapies should be targeted to maintain whole body’s functions. Extracorporeal membrane oxygenation represents a possible option for severe acute respiratory distress syndrome caused by sepsis.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11567/1220235
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