Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 13, Number 10, October 2022, pages 483-490

Be Patient: Prolonged Extracorporeal Membrane Oxygenation Support Including Full System Switch With Favorable Outcome

Figures

Figure 1.
Figure 1. Computed tomography (CT) images during intensive care unit therapy. Chest CT imaging of a 40-year-old patient with marked bilateral influenza pneumonia apically accentuated (a). In the 2-week course, increase of bipulmonary infiltrates with definable consolidations on both sides (b). Another 2 weeks later, further progression of bilateral infiltrates/consolidations in the setting of acute respiratory distress syndrome following influenza pneumonia involving the bilateral lungs and delineable bronchiectasis (c). In the 3-month follow-up, almost complete regression of ubiquitous pneumonic infiltrates with only residual reticular drawing proliferation in the bilateral upper lobes (d).
Figure 2.
Figure 2. Relevant events during the treatment period. dx refers to the respective day following extracorporeal membrane oxygenation (ECMO) implantation d0.
Figure 3.
Figure 3. (a) Initial extracorporeal membrane oxygenation (ECMO). (b) Temporal use of two ECMO devices at the same time. (c) ECMO circuit after complete exchange.
Figure 4.
Figure 4. Patient’s World Health Organization Disability Schedule 2.0 (WHODAS 2.0) score assessed by self-reporting. Left panel: patient’s WHODAS 2.0 overall score before and after extracorporeal membrane oxygenation (ECMO; dashed lines) compared with the general population score. Right panel: domain-specific score before and after ECMO.

Table

Table 1. Overview of Observed Bleeding Events in Combination With Administered Blood Products to Control Hemorrhage
 
Major bleeding eventsErythrocytesPlateletsFresh frozen plasmaProthrombin complex/PPSB (International Units)Fibrinogen (g)Factor VIII (International Units)Factor XIII (International Units)
PPSB: prothrombin, proconvertin, Stuart factor and antihemophilic B factor.
After puncture-dilatation tracheotomy100002,0002,500
Bleeding from intercostal artery after inserting chest drain6230502,500
Tracheostoma bleeding after cough blow3012,000300
Total transfusion during intensive care stay422122,000374,00017,500