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| Application of venous-arterial extracorporeal membrane oxygenation in patient with refractory sepsis-induced shock complicated with severe sepsis-induced cardiomyopathy: case report and literature review |
| Zhang Yu-mei, Ma Qing-bian, Ge Hong-xia, Zhang Zhe, Zheng Hui-ping, Yang Hang, Feng Hai-bo, Fu Yuan-hao |
| Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China |
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Abstract Patients with septic shock complicated with sepsis-induced cardiomyopathy were at extremely condition and high mortality during the acute phase. A 28-year old female with refractory septic shock complicated with severe sepsis-induced cardiomyopathy was cured in our emergency intensive care unit of Peking University Third Hospital. Complain of abdomen pain, diarrhea, and fever for 8 days, the patient rapidly showed a low blood pressure of 70/50 mm Hg, a sinus tachycardia of 139 beats per minute, anuria, yellow muddy secretion by abdominal paracentesis, abnormal liver function, hypokalemia, diffuse reduction of myocardial contraction in left and right ventricles, left ventricular ejection fraction of 15%, which could be explained by septic shock complicated with sepsis-induced cardiomyopathy, intra-abdominal infection, multi-organ dysfunction. Applicated with venous-arterial extracorporeal membrane oxygenation (VA-ECMO), supported with improved antibiotic therapy thorough venous, oral stomach tube, and intra-abdominal ways, the circulation failure was smoothly got through, and the patient overcome the low EF gap with ECMO, was cured and discharged. Although extremely critical, sepsis-induced shock and cardiomyopathy mostly shows a self-recovered characteristic of 7 to 10 days period. At this extremely critical window phase of circulation dysfunction, except active and effective antibiotic therapy, VA-ECMO is effective and key support applicant, and it can largely lower its mortality.
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Corresponding Authors:
Ma Qing-bian, E-mail: maqingbian@medmail.com.cn
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