Gabel Eilon, Gudzenko Vadim, Cruz Daniel, Ardehali Abbas, Fink Mitchell P
Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
J Intensive Care Med. 2015 Feb;30(2):115-8. doi: 10.1177/0885066613517069. Epub 2013 Dec 25.
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.
继发于中毒性休克综合征（TSS）的心肌病是一个罕见但可能危及生命的问题。我们报告了一例51岁男性病例，该患者出现严重的心源性休克和多器官功能衰竭，常规的静脉输液、血管升压药和正性肌力药物治疗无法对其进行有效治疗。静脉-动脉体外膜肺氧合（VA ECMO）作为恢复的桥梁被启用。在给予抗生素和静脉注射免疫球蛋白后，患者病情改善，并在6天后成功撤离ECMO。患者从多器官功能衰竭中康复，左心室射血分数从ECMO前的<10%提高到出院后8个月的65%。该病例支持这样一种观点，即VA ECMO可成功用于支持因TSS导致的严重但可逆性心肌病患者的重要器官灌注。
