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急性前 B 淋巴细胞白血病合并播散性军团菌病患者接受体外膜肺氧合支持治疗。

ECMO Support in Pre-B-Cell ALL for Disseminated Legionnaire's Disease.

机构信息

Louisiana State University Health Sciences Center, Children's Hospital New Orleans, New Orleans, Louisiana; and The University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas.

出版信息

J Extra Corpor Technol. 2021 Sep;53(3):204-207. doi: 10.1182/ject-2100020.

Abstract

is a common cause of community- and hospital-acquired pneumonia. Its increasing frequency and reemergence as a pathogen of interest in the intensive care unit is likely due to increased awareness, recognition, and diagnostic test availability (1). Extracorporeal Membrane Oxygenation (ECMO) is increasingly used in the pediatric intensive care unit (PICU) for refractory cardiopulmonary failure and acute respiratory distress syndrome (ARDS) in concert with conventional modalities or when these have failed to adequately support the patient. The breadth of applications for this technology are ever-expanding as our collective knowledge and experience grows. With a particularly high mortality rate among immunocompromised patients, Legionnaires' disease should be considered early in the differential diagnosis and appropriate antimicrobials initiated (1). We present the case of an adolescent patient with pre-B-cell acute lymphoblastic leukemia (pre-B ALL) requiring ECMO support for septic shock and ARDS due to disseminated . To our knowledge, this is the first case describing an immunocompromised pediatric patient supported with ECMO for Legionnaires' disease.

摘要

是社区获得性肺炎和医院获得性肺炎的常见病因。其在重症监护病房中作为一种重要病原体的频率增加和再次出现,可能是由于人们对其认识、识别和诊断检测手段的提高所致。体外膜氧合(ECMO)在儿科重症监护病房(PICU)中越来越多地用于难治性心肺衰竭和急性呼吸窘迫综合征(ARDS),与传统方法联合使用,或者在这些方法未能充分支持患者时使用。随着我们的集体知识和经验的增长,这项技术的应用范围不断扩大。由于免疫功能低下的患者死亡率特别高,军团菌病应在鉴别诊断中尽早考虑,并启动适当的抗菌药物治疗。我们报告了一例青少年患者,患有前 B 细胞急性淋巴细胞白血病(pre-B ALL),由于 播散性感染,需要 ECMO 支持以治疗感染性休克和 ARDS。据我们所知,这是首例描述免疫功能低下的儿科患者接受 ECMO 支持治疗军团菌病的病例。

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