Susan H Morris1, Ann E Haight, Pradip Kamat, James D Fortenberry. 1. Critical Care Division, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA. susan.morris@choa.org
Abstract
OBJECTIVE: To describe the successful use of extracorporeal life support in a hematopoietic stem cell transplant patient with diffuse alveolar hemorrhage. DESIGN: Case report. SETTING: Pediatric intensive care unit in a freestanding quaternary children's hospital. PATIENT: A 20-mo-old male with Hurler syndrome who developed respiratory failure from diffuse alveolar hemorrhage after hematopoietic stem cell transplant and was managed successfully with extracorporeal life support. INTERVENTION: Placement on extracorporeal membrane oxygenation. MEASUREMENTS AND MAIN RESULTS: Diffuse alveolar hemorrhage is a well-known complication in hematopoietic stem cell transplant patients, with an even higher occurrence in those with Hurler syndrome. Extracorporeal membrane oxygenation has been contraindicated traditionally in both pulmonary hemorrhage and hematopoietic stem cell transplant patients. We report the successful use of extracorporeal membrane oxygenation and survival to hospital discharge in a hematopoietic stem cell transplant patient with diffuse alveolar hemorrhage. CONCLUSION: Although the reported survival of hematopoietic stem cell transplant patients on extracorporeal membrane oxygenation remains low, each patient must be evaluated for potential benefit of extracorporeal life support.
OBJECTIVE: To describe the successful use of extracorporeal life support in a hematopoietic stem cell transplant patient with diffuse alveolar hemorrhage. DESIGN: Case report. SETTING: Pediatric intensive care unit in a freestanding quaternary children's hospital. PATIENT: A 20-mo-old male with Hurler syndrome who developed respiratory failure from diffuse alveolar hemorrhage after hematopoietic stem cell transplant and was managed successfully with extracorporeal life support. INTERVENTION: Placement on extracorporeal membrane oxygenation. MEASUREMENTS AND MAIN RESULTS: Diffuse alveolar hemorrhage is a well-known complication in hematopoietic stem cell transplant patients, with an even higher occurrence in those with Hurler syndrome. Extracorporeal membrane oxygenation has been contraindicated traditionally in both pulmonary hemorrhage and hematopoietic stem cell transplant patients. We report the successful use of extracorporeal membrane oxygenation and survival to hospital discharge in a hematopoietic stem cell transplant patient with diffuse alveolar hemorrhage. CONCLUSION: Although the reported survival of hematopoietic stem cell transplant patients on extracorporeal membrane oxygenation remains low, each patient must be evaluated for potential benefit of extracorporeal life support.
Authors: Matteo Di Nardo; Ali H Ahmad; Pietro Merli; Matthew S Zinter; Leslie E Lehman; Courtney M Rowan; Marie E Steiner; Sangeeta Hingorani; Joseph R Angelo; Hisham Abdel-Azim; Sajad J Khazal; Basirat Shoberu; Jennifer McArthur; Rajinder Bajwa; Saad Ghafoor; Samir H Shah; Hitesh Sandhu; Karen Moody; Brandon D Brown; Maria E Mireles; Diana Steppan; Taylor Olson; Lakshmi Raman; Brian Bridges; Christine N Duncan; Sung Won Choi; Rita Swinford; Matt Paden; James D Fortenberry; Giles Peek; Pierre Tissieres; Daniele De Luca; Franco Locatelli; Selim Corbacioglu; Martin Kneyber; Alessio Franceschini; Simon Nadel; Matthias Kumpf; Alessandra Loreti; Roelie Wösten-Van Asperen; Orsola Gawronski; Joe Brierley; Graeme MacLaren; Kris M Mahadeo Journal: Lancet Child Adolesc Health Date: 2021-12-09
Authors: Matt S Zinter; Jennifer McArthur; Christine Duncan; Roberta Adams; Erin Kreml; Heidi Dalton; Hisham Abdel-Azim; Courtney M Rowan; Shira J Gertz; Kris M Mahadeo; Adrienne G Randolph; Prakadeshwari Rajapreyar; Marie E Steiner; Leslie Lehmann Journal: Pediatr Crit Care Med Date: 2022-03-01 Impact factor: 3.624
Authors: M S Zinter; B D Barrows; P C Ursell; K Kowalek; K Kalantar; N Cambronero; J L DeRisi; P Oishi; C C Dvorak Journal: Bone Marrow Transplant Date: 2017-06-05 Impact factor: 5.483
Authors: Miguel Pardinas; Rodrigo Mendirichaga; Gaurav Budhrani; Rajan Garg; Luis Rosario; Rene Rico; Anthony Panos; Horst Baier; Stefanie Krick Journal: Clin Med Insights Circ Respir Pulm Med Date: 2017-03-02