Natacha Kapandji1, Alban Redheuil2,3, Pierre Fouret4, Guillaume Hékimian1,2, Guillaume Lebreton, Nicolas Bréchot1,2, Charles-Edouard Luyt1,2, Philippe Cluzel2,3, Alain Combes1,2, Matthieu Schmidt1,2. 1. Medical Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France. 2. Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France. 3. Department of Cardiovascular Imaging, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France. 4. Department of Anatomopathology, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France.
Abstract
OBJECTIVES: To describe an unusual complication on extracorporeal membrane oxygenation. DATA SOURCES: Clinical observation. STUDY SELECTION: Case report. DATA EXTRACTION: Relevant clinical information. DATA SYNTHESIS: We report the cases of three young patients who developed extensive myocardial calcifications on prolonged extracorporeal membrane oxygenation support for severe acute respiratory distress syndrome with septic cardiomyopathy, postresuscitation cardiogenic shock, and septic shock complicating severe acute respiratory distress syndrome, respectively. Extensive myocardial calcifications were confirmed by echocardiography, CT, and cardiac biopsy. The combination of multiple factors, for example, prolonged hemodynamic failure, profound acidosis, high vasopressor doses, and renal failure, may lead to this unusual and severe complication. CONCLUSIONS: Intensivists should be aware of this rare but rapid complication on extracorporeal membrane oxygenation support that may directly impact outcome. The precise role of extracorporeal membrane oxygenation support in the timing and frequency of new-onset diffuse myocardial calcification deserves further investigation.
OBJECTIVES: To describe an unusual complication on extracorporeal membrane oxygenation. DATA SOURCES: Clinical observation. STUDY SELECTION: Case report. DATA EXTRACTION: Relevant clinical information. DATA SYNTHESIS: We report the cases of three young patients who developed extensive myocardial calcifications on prolonged extracorporeal membrane oxygenation support for severe acute respiratory distress syndrome with septic cardiomyopathy, postresuscitation cardiogenic shock, and septic shock complicating severe acute respiratory distress syndrome, respectively. Extensive myocardial calcifications were confirmed by echocardiography, CT, and cardiac biopsy. The combination of multiple factors, for example, prolonged hemodynamic failure, profound acidosis, high vasopressor doses, and renal failure, may lead to this unusual and severe complication. CONCLUSIONS: Intensivists should be aware of this rare but rapid complication on extracorporeal membrane oxygenation support that may directly impact outcome. The precise role of extracorporeal membrane oxygenation support in the timing and frequency of new-onset diffuse myocardial calcification deserves further investigation.
Authors: Sasha B C P Duarte; Sandrigo Mangini; Monica S Avila; Marcelo L Montemor; Fernando Bacal Journal: Arq Bras Cardiol Date: 2020-01 Impact factor: 2.000