Extracorporeal membrane oxygenation in a patient with newly diagnosed acute myeloblastic leukaemia presenting with severe respiratory failure

Veno-venous extracorporeal membrane oxygenation (ECMO) is typically instituted in severe respiratory failure, defined by Lung Injury Score, and caused either by pulmonary or extra-pulmonary reversible disease processes. These processes will have led to acute worsening of oxygenation and/or respirato...

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Bibliographic Details
Published in:Journal of artificial organs 2021-09, Vol.24 (3), p.387-391
Main Authors: Pandey, Manish, Peetermans, Marijke, Doyle, Andrew J., Dillon, Richard, Meadows, Christopher I. S.
Format: Article
Language:English
Subjects:
Acidosis
Biomedical Engineering and Bioengineering
Blood cancer
Cardiac Surgery
Case Report
Chemotherapy
Extracorporeal membrane oxygenation
Failure
Hematology
Immunosuppression
Leukemia
Lung diseases
Lungs
Malignancy
Mechanical ventilation
Medicine
Medicine & Public Health
Membranes
Nephrology
Oxygenation
Patients
Pneumonia
Recovery of function
Remission
Respiratory failure
Signs and symptoms
Ventilation
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Summary:Veno-venous extracorporeal membrane oxygenation (ECMO) is typically instituted in severe respiratory failure, defined by Lung Injury Score, and caused either by pulmonary or extra-pulmonary reversible disease processes. These processes will have led to acute worsening of oxygenation and/or respiratory acidosis together with an inability to provide safe, lung protective, mechanical ventilation. Patients with underlying chronic immunosuppression or haematological malignancies treated with ECMO for severe respiratory failure have poor short- and long-term functional and survival outcomes. Consequently, in many centres, a diagnosis of haematological malignancy is considered a contraindication to provision of ECMO support for severe respiratory failure. We present a case of a 51-year-old female who attended her local hospital with symptoms suggestive of community-acquired pneumonia. Within a few days, there was progression to severe respiratory failure, initially managed with invasive mechanical ventilation but rapidly deteriorating respiratory failure triggered referral for ECMO support. Initial investigations on ECMO demonstrated features of acute myeloblastic leukaemia with a superimposed community-acquired pneumonia. This was successfully managed with supportive treatment alongside mechanical respiratory therapy and targeted chemotherapy, achieving complete remission and full functional recovery.
ISSN:1434-7229
1619-0904
DOI:10.1007/s10047-020-01225-5