Case report, case study
https://doi.org/10.3325/cmj.2023.64.28 4
Enterobacter cloacae septicemia in a triple-cannula extracorporeal membrane oxygenation circulatory support treated with Seraph100 Microbind affinity blood filter
Marin Pavlov
; Department of Cardiology, Dubrava University Hospital, Zagreb, Croatia
*
Tomislava Bodrožić Džakić Poljak
; Department of Cardiology, Dubrava University Hospital, Zagreb, Croatia
Nikola Pavlović
; Department of Cardiology, Dubrava University Hospital, Zagreb, Croatia
Sandra Šestan Crnek
; Department of Clinical Microbiology and Hospital Infections, Dubrava University Hospital, Zagreb, Croatia
Davor Barić
; Department of Cardiac and Transplant Surgery, Dubrava University Hospital, Zagreb, Croatia
Igor Rudež
; Department of Cardiac and Transplant Surgery, Dubrava University Hospital, Zagreb, Croatia
* Corresponding author.
Abstract
Bloodstream infections (BSI) are frequently encountered
during extracorporeal membrane oxygenation (ECMO)
support. Once septicemia is observed, treatment should
be rapid, adequate, and multifaceted, particularly in ad
-
vanced ECMO configurations. We report on a case of a
60-year-old male patient with acute-on-chronic heart fail
-
ure due to ischemic cardiomyopathy. The treatment was
complicated by cardiogenic shock requiring veno-arterial
ECMO support, and, due to persistent pulmonary conges
-
tion, an upgrade with an additional left-atrial drainage can
-
nula. After seven days of ECMO support, septicemia with
shock ensued. Ex iuvantibus antibiotic treatment was start
-
ed promptly. We wanted to minimize the likelihood of bac
-
terial biofilm build-up requiring an exchange of the ECMO
circuit and cannula, which was expected to be challeng
-
ing. Therefore, we added a Seraph-100 Microbind affinity
blood filter (providing blood purification with the poten
-
tial for rapid bacterial clearance) to the ECMO circuit. Ini
-
tial blood cultures tested positive for Enterobacter cloacae.
Following a course of Seraph-100 treatment, bacteremia,
septicemia, and shock resolved. There was no need for a
circuit or cannula exchange. The additional eleven days of
ECMO support were uneventful. The patient was success
-
fully bridged to long-term mechanical circulatory support.
We believe that the synergistic effect of early implemen
-
tation of both broad-spectrum antibiotic treatment and
blood purification with the potential for rapid bacterial
clearance (such as the one provided with the Seraph-100
Microbind affinity blood filter) is crucial in BSI in patients
receiving advanced ECMO.
Keywords
Hrčak ID:
331843
URI
Publication date:
31.8.2023.
Visits: 137 *