Medicina, Vol. 56 No. 4, 2020.
Ostalo
https://doi.org/10.21860/medflum2020_245235
Successful use of extracorporeal membrane oxygenation in the treatment of a patient with cardiogenic shock after renal transplantation
Zdravko Jurilj
orcid.org/0000-0001-5318-1819
; Klinika za anesteziologiju i intenzivno liječenje, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Berislav Barbalić
; Klinika za anesteziologiju i intenzivno liječenje, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Branka Čačić
; Klinika za anesteziologiju i intenzivno liječenje, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Hana Tunaj
; Klinika za anesteziologiju i intenzivno liječenje, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Sažetak
Aim: Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is a method of supporting cardiac function in patients with cardiogenic shock in whom medicament therapy is insufficient. The aim of this report is to show, by describing the course of the treatment of a patient with cardiogenic shock in the immediate postoperative period following a kidney transplant, the great potential of this treatment modality in such patients. The use of extracorporeal mechanical circulatory support allowed for both the survival of the patient and the maintenance of the transplanted organ’s function. Case report: A 61-year-old patient with end-stage chronic kidney disease was admitted to the Intensive care unit (ICU) after renal transplantation. The course of the surgery was complicated by the development of significant hemodynamic instability. Despite all the medicament treatment measures taken, the patient developed myocardial infarction with cardiogenic shock. Given that the condition was refractory to the applied drug therapy, a decision was made to initiate the extracorporeal mechanical support. Mechanical support led to hemodynamic stabilization of the patient and served as a bridge to recovery of cardiac function with successful preservation of transplant function Conclusions: In the growing number of papers that support this, mechanical circulatory support is the future of treatment for cardiogenic shock, regardless of its etiology. It is a method that carries its own risks which are slowly diminishing with the development of technology. It is becoming more widely available and its application is expanding to different patient groups. It is important to emphasize that the success of therapy requires the participation of specialists of different specialties in the treatment of such complex cases.
Ključne riječi
cardiogenic shock; extracorproreal mechanical support; kidney transplantation; veno-arterial extracorporeal membrane oxygenation
Hrčak ID:
245235
URI
Datum izdavanja:
1.12.2020.
Posjeta: 1.133 *