Medical Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France.
Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France.
Crit Care Med. 2018 Jul;46(7):e702-e706. doi: 10.1097/CCM.0000000000003130.
To describe an unusual complication on extracorporeal membrane oxygenation.
Clinical observation.
Case report.
Relevant clinical information.
We report the cases of three young patients who developed extensive myocardial calcifications on prolonged extracorporeal membrane oxygenation support for severe acute respiratory distress syndrome with septic cardiomyopathy, postresuscitation cardiogenic shock, and septic shock complicating severe acute respiratory distress syndrome, respectively. Extensive myocardial calcifications were confirmed by echocardiography, CT, and cardiac biopsy. The combination of multiple factors, for example, prolonged hemodynamic failure, profound acidosis, high vasopressor doses, and renal failure, may lead to this unusual and severe complication.
Intensivists should be aware of this rare but rapid complication on extracorporeal membrane oxygenation support that may directly impact outcome. The precise role of extracorporeal membrane oxygenation support in the timing and frequency of new-onset diffuse myocardial calcification deserves further investigation.
描述体外膜氧合中一种不常见的并发症。
临床观察。
病例报告。
相关临床信息。
我们报告了三例年轻患者的病例，他们分别因严重急性呼吸窘迫综合征并发脓毒性心肌病、心肺复苏后心源性休克和脓毒性休克而在体外膜氧合支持下发生严重的急性呼吸窘迫综合征，长时间后出现广泛的心肌钙化。超声心动图、CT 和心内膜活检证实了广泛的心肌钙化。多种因素的结合，例如长时间的血流动力学衰竭、严重酸中毒、大剂量血管加压药和肾功能衰竭，可能导致这种不常见和严重的并发症。
重症监护医生应该意识到这种在体外膜氧合支持下罕见但迅速发生的并发症，它可能直接影响预后。体外膜氧合支持在新发弥漫性心肌钙化的时间和频率中的作用值得进一步研究。
