Wheaton Taylor, Menkiti Ogechukwu, Misra Amit
Division of Critical Care Medicine, St. Christopher's Hospital for Children, Philadelphia, PA, USA.
Division of Neonatology, St. Christopher's Hospital for Children, Philadelphia, PA, USA.
Int J Artif Organs. 2020 Jul;43(7):500-502. doi: 10.1177/0391398820901832. Epub 2020 Jan 25.
Separately, refractory septic shock and purpura fulminans have very poor outcomes. The ethics involved in offering extracorporeal membrane oxygenation to very high-risk patients is complex. We report a novel case of refractory shock requiring veno-arterial extracorporeal membrane oxygenation and continuous renal replacement therapy due to bacteremia with purpura fulminans to highlight the ethical challenges in offering extracorporeal membrane oxygenation to a patient with such a poor likelihood of survival.
另外，难治性感染性休克和暴发性紫癜的预后非常差。为极高风险患者提供体外膜肺氧合所涉及的伦理问题很复杂。我们报告了一例因暴发性紫癜菌血症导致难治性休克的新病例，该患者需要静脉-动脉体外膜肺氧合和持续肾脏替代治疗，以突出为生存可能性极低的患者提供体外膜肺氧合所面临的伦理挑战。
