Successful management of harlequin syndrome due to pulmonary hemorrhage and atelectasis with VAV- ECMO
Introduction Pulmonary hemorrhage is a life-threatening complication of VA-ECMO occasionally presenting with Harlequin syndrome. Case report We present a case of a VA-ECMO patient complicated with pulmonary hemorrhage, complete right lung atelectasis and differential hypoxia refractory to convention...
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| Veröffentlicht in: | Perfusion 2024-09, Vol.39 (6), p.1259-1264 |
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| creator | Antonogiannakis, Anastasios Antonopoulos, Mixalis Elaiopoulos, Dimitrios Leontiadis, Evaggelos Ieromonachos, Konstantinos Adamopoulos, Stamatios Chamogeorgakis, Themistoklis Dimopoulos, Stavros |
| description | Introduction
Pulmonary hemorrhage is a life-threatening complication of VA-ECMO occasionally presenting with Harlequin syndrome.
Case report
We present a case of a VA-ECMO patient complicated with pulmonary hemorrhage, complete right lung atelectasis and differential hypoxia refractory to conventional treatment including optimal mechanical ventilation and bronchoscopy interventions. Patient was successfully managed by conversion of VA to VAV-ECMO.
Discussion
Pulmonary hemorrhage and atelectasis treatment in a VA-ECMO patient includes transfusion, hold and reversal of anticoagulation, bronchoscopy interventions and optimization of VA-ECMO and ventilator support. Differential hypoxia may ensue due to residual native cardiac function. If refractory to conservative treatment, a VAV-ECMO configuration may be utilized to improve upper body oxygenation by inserting an additional cannula to the superior vena cava.
Conclusion
VAV-ECMO is an ECMO configuration support in patients at risk of Harlequin syndrome presenting with pulmonary hemorrhage. |
| doi_str_mv | 10.1177/02676591231181847 |
| format | Article |
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Pulmonary hemorrhage is a life-threatening complication of VA-ECMO occasionally presenting with Harlequin syndrome.
Case report
We present a case of a VA-ECMO patient complicated with pulmonary hemorrhage, complete right lung atelectasis and differential hypoxia refractory to conventional treatment including optimal mechanical ventilation and bronchoscopy interventions. Patient was successfully managed by conversion of VA to VAV-ECMO.
Discussion
Pulmonary hemorrhage and atelectasis treatment in a VA-ECMO patient includes transfusion, hold and reversal of anticoagulation, bronchoscopy interventions and optimization of VA-ECMO and ventilator support. Differential hypoxia may ensue due to residual native cardiac function. If refractory to conservative treatment, a VAV-ECMO configuration may be utilized to improve upper body oxygenation by inserting an additional cannula to the superior vena cava.
Conclusion
VAV-ECMO is an ECMO configuration support in patients at risk of Harlequin syndrome presenting with pulmonary hemorrhage.</description><identifier>ISSN: 0267-6591</identifier><identifier>ISSN: 1477-111X</identifier><identifier>EISSN: 1477-111X</identifier><identifier>DOI: 10.1177/02676591231181847</identifier><identifier>PMID: 37272740</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Anemia, Hemolytic - complications ; Anemia, Hemolytic - etiology ; Anemia, Hemolytic - therapy ; Anticoagulants ; Atelectasis ; Autonomic Nervous System Diseases ; Bronchoscopy ; Configurations ; Extracorporeal Membrane Oxygenation - methods ; Flushing - etiology ; Hemorrhage ; Hemorrhage - etiology ; Hemorrhage - therapy ; Humans ; Hypohidrosis - complications ; Hypoxia ; Lung Diseases - complications ; Male ; Mechanical ventilation ; Oxygenation ; Pulmonary Atelectasis - etiology ; Pulmonary Atelectasis - therapy</subject><ispartof>Perfusion, 2024-09, Vol.39 (6), p.1259-1264</ispartof><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c320t-283e7a7c0e8b6b6d13046d37c0d8175a84f176c14c3c1bea04bf3bd4a9c9f3d53</cites><orcidid>0000-0003-2199-3788</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/02676591231181847$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/02676591231181847$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>315,781,785,21824,27929,27930,43626,43627</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37272740$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Antonogiannakis, Anastasios</creatorcontrib><creatorcontrib>Antonopoulos, Mixalis</creatorcontrib><creatorcontrib>Elaiopoulos, Dimitrios</creatorcontrib><creatorcontrib>Leontiadis, Evaggelos</creatorcontrib><creatorcontrib>Ieromonachos, Konstantinos</creatorcontrib><creatorcontrib>Adamopoulos, Stamatios</creatorcontrib><creatorcontrib>Chamogeorgakis, Themistoklis</creatorcontrib><creatorcontrib>Dimopoulos, Stavros</creatorcontrib><title>Successful management of harlequin syndrome due to pulmonary hemorrhage and atelectasis with VAV- ECMO</title><title>Perfusion</title><addtitle>Perfusion</addtitle><description>Introduction
Pulmonary hemorrhage is a life-threatening complication of VA-ECMO occasionally presenting with Harlequin syndrome.
Case report
We present a case of a VA-ECMO patient complicated with pulmonary hemorrhage, complete right lung atelectasis and differential hypoxia refractory to conventional treatment including optimal mechanical ventilation and bronchoscopy interventions. Patient was successfully managed by conversion of VA to VAV-ECMO.
Discussion
Pulmonary hemorrhage and atelectasis treatment in a VA-ECMO patient includes transfusion, hold and reversal of anticoagulation, bronchoscopy interventions and optimization of VA-ECMO and ventilator support. Differential hypoxia may ensue due to residual native cardiac function. If refractory to conservative treatment, a VAV-ECMO configuration may be utilized to improve upper body oxygenation by inserting an additional cannula to the superior vena cava.
Conclusion
VAV-ECMO is an ECMO configuration support in patients at risk of Harlequin syndrome presenting with pulmonary hemorrhage.</description><subject>Anemia, Hemolytic - complications</subject><subject>Anemia, Hemolytic - etiology</subject><subject>Anemia, Hemolytic - therapy</subject><subject>Anticoagulants</subject><subject>Atelectasis</subject><subject>Autonomic Nervous System Diseases</subject><subject>Bronchoscopy</subject><subject>Configurations</subject><subject>Extracorporeal Membrane Oxygenation - methods</subject><subject>Flushing - etiology</subject><subject>Hemorrhage</subject><subject>Hemorrhage - etiology</subject><subject>Hemorrhage - therapy</subject><subject>Humans</subject><subject>Hypohidrosis - complications</subject><subject>Hypoxia</subject><subject>Lung Diseases - complications</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Oxygenation</subject><subject>Pulmonary Atelectasis - etiology</subject><subject>Pulmonary Atelectasis - therapy</subject><issn>0267-6591</issn><issn>1477-111X</issn><issn>1477-111X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtLxDAUhYMoOj5-gBsJuHFTzU0yTbuUwRcoLnzgrqTJrVNpmzFpEP-9GcYHKJLFheQ75-aeS8g-sGMApU4Yz1U-LYELgAIKqdbIBKRSGQA8rZPJ8j1bAltkO4QXxpiUUmySLaF4OpJNSHMXjcEQmtjRXg_6GXscRuoaOte-w9fYDjS8D9a7HqmNSEdHF7Hr3aD9O51j77yfJxXVg6V6xA7NqEMb6Fs7zunj6WNGz2Y3t7tko9FdwL3PukMezs_uZ5fZ9e3F1ez0OjOCszHjhUCllWFY1HmdWxBM5lakC1uAmupCNqByA9IIAzVqJutG1Fbq0pSNsFOxQ45WvgvvXiOGserbYLDr9IAuhooXnCumypIn9PAX-uKiH9LvqhQn4yCkYImCFWW8C8FjUy1826fZK2DVcgnVnyUkzcGnc6x7tN-Kr9QTcLwCQkrup-3_jh-Iio6b</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Antonogiannakis, Anastasios</creator><creator>Antonopoulos, Mixalis</creator><creator>Elaiopoulos, Dimitrios</creator><creator>Leontiadis, Evaggelos</creator><creator>Ieromonachos, Konstantinos</creator><creator>Adamopoulos, Stamatios</creator><creator>Chamogeorgakis, Themistoklis</creator><creator>Dimopoulos, Stavros</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2199-3788</orcidid></search><sort><creationdate>20240901</creationdate><title>Successful management of harlequin syndrome due to pulmonary hemorrhage and atelectasis with VAV- ECMO</title><author>Antonogiannakis, Anastasios ; Antonopoulos, Mixalis ; Elaiopoulos, Dimitrios ; Leontiadis, Evaggelos ; Ieromonachos, Konstantinos ; Adamopoulos, Stamatios ; Chamogeorgakis, Themistoklis ; Dimopoulos, Stavros</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c320t-283e7a7c0e8b6b6d13046d37c0d8175a84f176c14c3c1bea04bf3bd4a9c9f3d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Anemia, Hemolytic - complications</topic><topic>Anemia, Hemolytic - etiology</topic><topic>Anemia, Hemolytic - therapy</topic><topic>Anticoagulants</topic><topic>Atelectasis</topic><topic>Autonomic Nervous System Diseases</topic><topic>Bronchoscopy</topic><topic>Configurations</topic><topic>Extracorporeal Membrane Oxygenation - methods</topic><topic>Flushing - etiology</topic><topic>Hemorrhage</topic><topic>Hemorrhage - etiology</topic><topic>Hemorrhage - therapy</topic><topic>Humans</topic><topic>Hypohidrosis - complications</topic><topic>Hypoxia</topic><topic>Lung Diseases - complications</topic><topic>Male</topic><topic>Mechanical ventilation</topic><topic>Oxygenation</topic><topic>Pulmonary Atelectasis - etiology</topic><topic>Pulmonary Atelectasis - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Antonogiannakis, Anastasios</creatorcontrib><creatorcontrib>Antonopoulos, Mixalis</creatorcontrib><creatorcontrib>Elaiopoulos, Dimitrios</creatorcontrib><creatorcontrib>Leontiadis, Evaggelos</creatorcontrib><creatorcontrib>Ieromonachos, Konstantinos</creatorcontrib><creatorcontrib>Adamopoulos, Stamatios</creatorcontrib><creatorcontrib>Chamogeorgakis, Themistoklis</creatorcontrib><creatorcontrib>Dimopoulos, Stavros</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Perfusion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Antonogiannakis, Anastasios</au><au>Antonopoulos, Mixalis</au><au>Elaiopoulos, Dimitrios</au><au>Leontiadis, Evaggelos</au><au>Ieromonachos, Konstantinos</au><au>Adamopoulos, Stamatios</au><au>Chamogeorgakis, Themistoklis</au><au>Dimopoulos, Stavros</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Successful management of harlequin syndrome due to pulmonary hemorrhage and atelectasis with VAV- ECMO</atitle><jtitle>Perfusion</jtitle><addtitle>Perfusion</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>39</volume><issue>6</issue><spage>1259</spage><epage>1264</epage><pages>1259-1264</pages><issn>0267-6591</issn><issn>1477-111X</issn><eissn>1477-111X</eissn><abstract>Introduction
Pulmonary hemorrhage is a life-threatening complication of VA-ECMO occasionally presenting with Harlequin syndrome.
Case report
We present a case of a VA-ECMO patient complicated with pulmonary hemorrhage, complete right lung atelectasis and differential hypoxia refractory to conventional treatment including optimal mechanical ventilation and bronchoscopy interventions. Patient was successfully managed by conversion of VA to VAV-ECMO.
Discussion
Pulmonary hemorrhage and atelectasis treatment in a VA-ECMO patient includes transfusion, hold and reversal of anticoagulation, bronchoscopy interventions and optimization of VA-ECMO and ventilator support. Differential hypoxia may ensue due to residual native cardiac function. If refractory to conservative treatment, a VAV-ECMO configuration may be utilized to improve upper body oxygenation by inserting an additional cannula to the superior vena cava.
Conclusion
VAV-ECMO is an ECMO configuration support in patients at risk of Harlequin syndrome presenting with pulmonary hemorrhage.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>37272740</pmid><doi>10.1177/02676591231181847</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-2199-3788</orcidid></addata></record> |
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| subjects | Anemia, Hemolytic - complications Anemia, Hemolytic - etiology Anemia, Hemolytic - therapy Anticoagulants Atelectasis Autonomic Nervous System Diseases Bronchoscopy Configurations Extracorporeal Membrane Oxygenation - methods Flushing - etiology Hemorrhage Hemorrhage - etiology Hemorrhage - therapy Humans Hypohidrosis - complications Hypoxia Lung Diseases - complications Male Mechanical ventilation Oxygenation Pulmonary Atelectasis - etiology Pulmonary Atelectasis - therapy |
| title | Successful management of harlequin syndrome due to pulmonary hemorrhage and atelectasis with VAV- ECMO |
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