TY  - JOUR
A1  - Kredel, Markus
A1  - Kunzmann, Steffen
A1  - Schlegel, Paul-Gerhardt
A1  - Wölfl, Matthias
A1  - Nordbeck, Peter
A1  - Bühler, Christoph
A1  - Lotz, Christopher
A1  - Lepper, Philipp M.
A1  - Wirbelauer, Johannes
A1  - Roewer, Norbert
A1  - Muellenbach, Ralf M.
T1  - Double Peripheral Venous and Arterial Cannulation for Extracorporeal Membrane Oxygenation in Combined Septic and Cardiogenic Shock
JF  - American Journal of Case Reports
N2  - Background: 
The use of venoarterial extracorporeal membrane oxygenation (va-ECMO) via peripheral cannulation for septic shock is limited by blood flow and increased afterload for the left ventricle.

Case Report: 
A 15-year-old girl with acute myelogenous leukemia, suffering from severe septic and cardiogenic shock, was treated by venoarterial extracorporeal membrane oxygenation (va-ECMO). Sufficient extracorporeal blood flow matching the required oxygen demand could only be achieved by peripheral cannulation of both femoral arteries. Venous drainage was performed with a bicaval cannula inserted via the left V. femoralis. To accomplish left ventricular unloading, an additional drainage cannula was placed in the left atrium via percutaneous atrioseptostomy (va-va-ECMO). Cardiac function recovered and the girl was weaned from the ECMO on day 6. Successful allogenic stem cell transplantation took place 2 months later.

Conclusions: 
In patients with vasoplegic septic shock and impaired cardiac contractility, double peripheral venoarterial extracorporeal membrane oxygenation (va-va-ECMO) with transseptal left atrial venting can by a lifesaving option.
KW  - extracorporeal membrane oxygenation
KW  - myeloid
KW  - leukemia
KW  - acute
KW  - shock
KW  - cardiogenic
KW  - septic
Y1  - 2017
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-158193
VL  - 18
ER  -