Extracorporeal Membrane Oxygenation for Diffuse Alveolar Hemorrhage Caused by Idiopathic Pulmonary Hemosiderosis: A Case Report and a Review of the Literature.
Shotaro MatsumotoSatoshi NakagawaPublished in: Journal of pediatric intensive care (2019)
Diffuse alveolar hemorrhage (DAH) is a life-threatening condition presenting with hemoptysis, anemia, and diffuse radiographic pulmonary infiltrates; it causes acute respiratory failure. Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of DAH occurring predominantly in children. Bleeding is often considered to be a contraindication for extracorporeal membrane oxygenation (ECMO) due to systemic anticoagulation. We present an 8-year-old girl with DAH caused by IPH. Unfractionated heparin was administered to maintain an activated clotting time of 150 to 180 seconds. The DAH resolved with immunosuppressive therapy, and the patient survived to decannulation. ECMO may be applied as a rescue therapy for DAH even with systemic anticoagulation.
Keyphrases
- extracorporeal membrane oxygenation
- respiratory failure
- acute respiratory distress syndrome
- pulmonary hypertension
- atrial fibrillation
- venous thromboembolism
- low grade
- mechanical ventilation
- case report
- young adults
- chronic kidney disease
- stem cells
- intensive care unit
- high grade
- liver failure
- mesenchymal stem cells
- cell therapy