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Case Reports
. 2016 Jun;10(6):OD10-1.
doi: 10.7860/JCDR/2016/20649.7969. Epub 2016 Jun 1.

ECMO Rescue Therapy in Diffuse Alveolar Haemorrhage: A Case Report with Review of Literature

Gautam Rawal  1 , Raj Kumar  2 , Sankalp Yadav  3
Affiliations
Case Reports

ECMO Rescue Therapy in Diffuse Alveolar Haemorrhage: A Case Report with Review of Literature

Gautam Rawal et al. J Clin Diagn Res. 2016 Jun.

Abstract

Extracorporeal Membrane Oxygenation (ECMO) has evolved as a treatment option for patients having potentially reversible severe respiratory failure who are deteriorating on conventional ventilation. During ECMO, systemic anticoagulation is needed to maintain patency of the circuit. Therefore, ongoing haemorrhage remains a relative contra-indication to ECMO as it can further increase the bleeding. There is only limited evidence available for the use of ECMO in patients with alveolar haemorrhage. Most of these patients did not receive any anticoagulation during ECMO. We describe our experience with a patient who received intravenous anticoagulation during ECMO for refractory hypoxemic respiratory failure due to Diffuse Alveolar Haemorrhage (DAH) associated with Granulomatosis polyangitis (Wegner's GPA). ECMO sustained life by maintaining gas exchange support and provided the time for the immunotherapy to be effective. We report the successful use of anticoagulation during ECMO in a patient with DAH.

Keywords: Extracorporeal membrane oxygenation; Granulomatosis polyangiitis; Haemoptysis; Systemic anticoagulation.

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Figures

[Table/Fig-1]:
[Table/Fig-1]:
Chest X-ray showing Bilateral alveolar infiltrates due to diffuse haemorrhage with bilateral intercostal drains with endotracheal tube and right internal jugular ECMO cannula
See this image and copyright information in PMC

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