Extracorporeal Membrane Oxygenation in a Patient With Refractory Acute Respiratory Distress Syndrome Secondary to Toxic Epidermal Necrolysis.
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
Pagination or Media Count:
Toxic epidermal necrolysis TEN is a rare condition affecting an estimated 1 to 2 cases per million per year, with reported mortality between 30 and 50 typically because of multiorgan failure or sepsis. Acute pulmonary complications from this disorder include bronchial mucosal sloughing, pulmonary edema, and infectious pneumonitis. Pulmonary complications in TEN occurred in 46 of patients in one series. Use of extracorporeal life support ECLS in adults with acute respiratory distress syndrome ARDS has increased markedly during the past few years after successful treatment in adults with swine flu H1N1 and publication of the CESAR conventional ventilation or ECMO for severe adult respiratory failure trial, which demonstrated a lower mortality and disability at 6 months for patients referred to an ECLS center. The suggested ideal candidate for ECLS would be one with an acute, reversible, survivable illness if not for associated ARDS, no significant comorbidities, no contraindication to systemic anticoagulation, less than 8 days on mechanical ventilation, and younger than 65 years of age.
- Anatomy and Physiology
- Medicine and Medical Research
- Life Support Systems