- Pulmonary
-
Direct hemoperfusion with polymyxin B-immobilized fiber column in a patient with acute exacerbation of idiopathic pulmonary fibrosis
-
Shin Young Kim, Jin Han Park, Hyo Jung Kim, Hang Jea Jang, Hyun Kuk Kim, Seung Hoon Kim, Jae Ha Lee
-
Acute Crit Care. 2020;35(4):302-306. Published online April 13, 2020
-
DOI: https://doi.org/10.4266/acc.2020.00038
-
-
 Abstract
 PDF
- Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease characterized by dyspnea and a worsening of the lung function. Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) are defined by a clinically significant respiratory deterioration, that typically develops in less than 1 month, accompanied by new radiologic abnormalities on high-resolution computed tomography, including diffused and bilateral ground-glass opacification, along with an absence of other obvious clinical etiologies. Recently, AE-IPF has gained significant importance as a major cause of mortality and morbidity. However, despite the extremely poor prognosis of the condition, no well-validated therapeutic interventions are currently available. Therefore, novel treatment modalities are being investigated and applied in addition to conventional treatments. Among them, several studies have reported that a direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP), developed for endotoxin removal in septic shock, has an effect on AE-IPF. We describe two cases of PMX-DHP treatment with conflicting results. One patient successfully recovered via a PMX-DHP in severe AE-IPF that required extracorporeal membrane oxygenation (ECMO). PMX-DHP subsequently improved oxygenation (PaO2/FiO2 ratio) and decreased the levels of inflammatory markers (interleukin-6, C-reactive protein, and white blood cells). The patient dramatically recovered without the need for ECMO. PMX-DHP may be considered an alternative therapy in AE-IPF patients requiring mechanical ventilation or ECMO.
- Obstetric/Cardiology
-
Use of Extracorporeal Membrane Oxygenation in a Fulminant Course of Amniotic Fluid Embolism Syndrome Immediately after Cesarean Delivery
-
Jae Ha Lee, Hang Jea Jang, Jin Han Park, Yong Kyun Kim, Ho Ki Min, Sun Young Kim, Hyun-kuk Kim
-
Korean J Crit Care Med. 2016;31(3):256-261. Published online August 30, 2016
-
DOI: https://doi.org/10.4266/kjccm.2016.00213
-
-
8,433
View
-
149
Download
-
2
Crossref
-
Abstract
PDF
- Amniotic fluid embolism is rare but is one of the most catastrophic complications in the peripartum period. This syndrome is caused by a maternal anaphylactic reaction to the introduction of fetal material into the pulmonary circulation. When amniotic fluid embolism is suspected, the immediate application of extracorporeal mechanical circulatory support such as veno-arterial extracorporeal membrane oxygenation (ECMO) or cardiopulmonary bypass should be considered. Without the application of extracorporeal mechanical circulatory support, medical supportive care might not be sufficient to maintain cardiopulmonary stabilization in severe cases of amniotic fluid embolism. In this report, we present the case of a 36-year-old pregnant woman who developed an amniotic fluid embolism immediately after a cesarean section. Her catastrophic event started with the sudden onset of severe hypoxia, followed by circulatory collapse within 8 minutes. The veno-arterial mode of extracorporeal membrane oxygenation was initiated immediately. She was successfully resuscitated but with impaired cognitive function. Thus, urgent ECMO should be considered when amniotic fluid embolism syndrome is suspected in patients presenting acute cardiopulmonary collapse.
-
Citations
Citations to this article as recorded by  - Venoarterial Extracorporeal Membrane Oxygenation as Supportive Therapy After Cardiac Arrest After Amniotic Fluid Embolism: A Case Report
Claire Depondt, Darko Arnaudovski, Audrey Voulgaropoulos, Olivier Milleron, Walid Ghodbane, Alexy Tran Dinh, Philippe Montravers, Elie Kantor
A&A Practice.2019; 13(2): 74. CrossRef - Urgent Application of Extracorporeal Membrane Oxygenation in Amniotic Fluid Embolism
Moo Suk Park
The Korean Journal of Critical Care Medicine.2016; 31(3): 179. CrossRef
|
KSCCM
