Extracorporeal membrane oxygenation and severe acute respiratory distress secondary to Legionella: 10 year experience

• Published in: ASAIO journal (1992) Vol. 59; no. 3; p. 328
• Main Authors: Noah, Moronke A, Ramachandra, Geethanjali, Hickey, Margaret M, Jenkins, David R, Harvey, Chris J, Westrope, Claire A, Firmin, Richard K, Peek, Giles J
• Format: Journal Article
• Language: English
• Published: United States 01.05.2013
• Subjects: Adult; Extracorporeal Membrane Oxygenation - adverse effects; Extracorporeal Membrane Oxygenation - methods; Female; Humans; Legionella; Legionellosis - complications; Legionellosis - therapy; Male; Middle Aged; Respiratory Distress Syndrome, Adult - microbiology; Respiratory Distress Syndrome, Adult - therapy; Respiratory Insufficiency - etiology; Respiratory Insufficiency - therapy; Retrospective Studies; Survival Rate; Treatment Outcome
• ISSN: 1538-943X
• DOI: 10.1097/MAT.0b013e31829119c6

Legionella-associated respiratory failure has a high mortality, despite modern ventilation modalities. Extracorporeal membrane oxygenation (ECMO) is used to achieve gas exchange independent of pulmonary function in patients with severe respiratory failure. This was a retrospective review of the management and outcome of patients with Legionella-associated respiratory failure treated with ECMO support in a large ECMO center over the past 10 years. A retrospective review of patients with confirmed Legionella-associated severe respiratory failure managed with ECMO support at a single center. Between 2000 and 2010, 19 patients with severe respiratory failure caused by Legionella were managed with ECMO after failure to respond to conventional intensive care management. Median PaO2/FiO2 ratio was 66 and median pCO2 was 60 torr. Sixteen patients (84%) survived to hospital discharge. Extracorporeal membrane oxygenation should be considered in patients with Legionella-associated respiratory failure, who have failed conventional ventilation.