Extracorporeal membrane oxygenation in the management of granulomatosis with polyangiitis
| العنوان: | Extracorporeal membrane oxygenation in the management of granulomatosis with polyangiitis |
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| المؤلفون: | Niloo M. Edwards, Kanhua Yin, Robert J. March, Charles W. Hoopes, Nikola Dobrilovic, Robert A. Balk, Erica Bak, Ankur Tiwari, Karl J. Karlson, Jaishankar Raman, Omar Lateef |
| المصدر: | Journal of Cardiac Surgery. 36:743-747 |
| بيانات النشر: | Hindawi Limited, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, medicine.medical_treatment, Respiratory infection, Diffuse alveolar hemorrhage, 030204 cardiovascular system & hematology, medicine.disease, Surgery, 03 medical and health sciences, surgical procedures, operative, 0302 clinical medicine, 030228 respiratory system, Interquartile range, medicine, Extracorporeal membrane oxygenation, Respiratory function, Cardiology and Cardiovascular Medicine, Granulomatosis with polyangiitis, Complication, Vasculitis, business |
| الوصف: | Granulomatosis with polyangiitis (GPA, also known as Wegener's granulomatosis) is a type of systematic vasculitis that primarily involves the lung and kidney. Diffuse alveolar hemorrhage (DAH) and associated acute respiratory failure are uncommon but devastating complications of GPA. Experience in using extracorporeal membrane oxygenation (ECMO) to manage DAH caused by GPA is limited. We report two GPA patients with DAH that were successfully managed using ECMO support. Examining 13 cases identified in the literature and two of our own, we observed that most patients experienced rapid deterioration in respiratory function in conjunction with a precedent respiratory infection. All 15 patients received veno-venous ECMO support. The median duration of ECMO support was 11 days (interquartile range: 7.5-20.75 days). Bleeding was the most common complication, seen in four (26.7%) cases. All patients were successfully weaned off ECMO after a median length of hospital stay of 42 days (interquartile range: 30-78 days). We demonstrated that the use of ECMO is a reasonable and effective support option in the management of GPA patients with DAH. The risk of bleeding is high but maybe reduced using a lower anticoagulation goal. |
| تدمد: | 1540-8191 0886-0440 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::3232ec6f07f715034f1d42a5fd0f447c https://doi.org/10.1111/jocs.15252 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi...........3232ec6f07f715034f1d42a5fd0f447c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15408191 08860440 |
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