Successful use of extracorporeal membrane oxygenation in an adult patient with toxic shock-induced heart failure

Eilon Gabel; Vadim Gudzenko; Daniel Cruz; Abbas Ardehali; Mitchell P Fink

doi:10.1177/0885066613517069

Successful use of extracorporeal membrane oxygenation in an adult patient with toxic shock-induced heart failure

J Intensive Care Med. 2015 Feb;30(2):115-8. doi: 10.1177/0885066613517069. Epub 2013 Dec 25.

Authors

Eilon Gabel¹, Vadim Gudzenko², Daniel Cruz³, Abbas Ardehali⁴, Mitchell P Fink⁵

Affiliations

¹ Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
² Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA vgudzenko@mednet.ucla.edu.
³ Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
⁴ Division of Cardiac Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
⁵ Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

PMID: 24371250
DOI: 10.1177/0885066613517069

Abstract

Cardiomyopathy secondary to toxic shock syndrome (TSS) is an uncommon but potentially life-threatening problem. We report the case of a 51-year-old male who presented with profound cardiogenic shock and multiorgan failure that could not be managed by conventional therapy with intravenous fluids, vasopressors and inotropes. Venoarterial extracorporeal membrane oxygenation (VA ECMO) was instituted as a bridge to recovery. After administration of antibiotics and intravenous immunoglobulin, the patient's condition improved and he was successfully weaned off ECMO after 6 days. The patient recovered from multiorgan failure, and left ventricular ejection fraction improved from <10% pre-ECMO to 65% 8 months after discharge. This case supports the view that VA ECMO can be used successfully to support vital organ perfusion in patients with profound but reversible cardiomyopathy attributed to TSS.

Keywords: ECMO; cardiomyopathy; heart failure; sepsis; toxic shock syndrome.

Publication types

Case Reports

MeSH terms

Anti-Bacterial Agents / administration & dosage
Extracorporeal Membrane Oxygenation*
Exudates and Transudates / microbiology
Hemodynamics
Humans
Intensive Care Units
Leg Ulcer / microbiology*
Male
Middle Aged
Multiple Organ Failure / immunology*
Multiple Organ Failure / physiopathology
Multiple Organ Failure / therapy
Respiration, Artificial
Shock, Cardiogenic / immunology*
Shock, Cardiogenic / physiopathology
Shock, Cardiogenic / therapy
Shock, Septic / immunology*
Shock, Septic / physiopathology
Shock, Septic / therapy
Staphylococcal Skin Infections / immunology
Staphylococcal Skin Infections / microbiology*
Streptococcal Infections / immunology
Streptococcal Infections / microbiology*
Treatment Outcome

Substances

Anti-Bacterial Agents