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  - 
TY  - JOUR
A1  - Busch, Albert
A1  - Lorenz, Udo
A1  - Tiurbe, George Christian
A1  - Bühler, Christoph
A1  - Kellersmann, Richard
T1  - Femoral vein obturator bypass revascularization in groin infectious bleeding: two case reports and review of the literature
JF  - Journal of Medical Case Reports
N2  - Introduction

Groin infections resulting in arterial bleeding due to bacterial vessel destruction are a severe challenge in vascular surgery. Patients with them most often present as emergencies and therefore need individualized reconstruction solutions.

Case presentation

Case 1 is a 67-year-old man with infectious bleeding after an autologous reconstruction of the femoral bifurcation with greater saphenous vein due to infection of a bovine pericard patch after thrombendarterectomy. Case 2 is a 35-year-old male drug addict and had severe femoral bleeding and infection after repeated intravenous and intra-arterial substance abuse. Both patients were treated with an autologous obturator bypass of the superficial femoral vein. We review the current literature and highlight our therapeutic concept of this clinical entity.

Conclusions

Treatment should include systemic antibiotic medication, surgical control of the infectious site, revascularization and soft tissue repair. An extra-anatomical obturator bypass with autologous superficial femoral vein should be considered as the safest revascularization procedure in infections caused by highly pathogenic bacteria.
KW  - Obturator bypass
KW  - Groin infection
KW  - Autologous
KW  - Extra-anatomical
KW  - Femoral vein
Y1  - 2013
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-95901
UR  - http://www.jmedicalcasereports.com/content/7/1/75
ER  -