Successful use of extracorporeal membrane oxygenation in an adult patient with toxic shock-induced heart failure

• Published in: Journal of intensive care medicine Vol. 30; no. 2; p. 115
• Main Authors: Gabel, Eilon, Gudzenko, Vadim, Cruz, Daniel, Ardehali, Abbas, Fink, Mitchell P
• Format: Journal Article
• Language: English
• Published: United States 01.02.2015
• Subjects: Anti-Bacterial Agents - administration & dosage; Extracorporeal Membrane Oxygenation; Exudates and Transudates - microbiology; Hemodynamics; Humans; Intensive Care Units; Leg Ulcer - microbiology; Male; Middle Aged; Multiple Organ Failure - immunology; Multiple Organ Failure - physiopathology; Multiple Organ Failure - therapy; Respiration, Artificial; Shock, Cardiogenic - immunology; Shock, Cardiogenic - physiopathology; Shock, Cardiogenic - therapy; Shock, Septic - immunology; Shock, Septic - physiopathology; Shock, Septic - therapy; Staphylococcal Skin Infections - immunology; Staphylococcal Skin Infections - microbiology; Streptococcal Infections - immunology; Streptococcal Infections - microbiology; Treatment Outcome; ECMO; heart failure; toxic shock syndrome; cardiomyopathy; sepsis
• DOI: 10.1177/0885066613517069

Cardiomyopathy secondary to toxic shock syndrome (TSS) is an uncommon but potentially life-threatening problem. We report the case of a 51-year-old male who presented with profound cardiogenic shock and multiorgan failure that could not be managed by conventional therapy with intravenous fluids, vasopressors and inotropes. Venoarterial extracorporeal membrane oxygenation (VA ECMO) was instituted as a bridge to recovery. After administration of antibiotics and intravenous immunoglobulin, the patient's condition improved and he was successfully weaned off ECMO after 6 days. The patient recovered from multiorgan failure, and left ventricular ejection fraction improved from <10% pre-ECMO to 65% 8 months after discharge. This case supports the view that VA ECMO can be used successfully to support vital organ perfusion in patients with profound but reversible cardiomyopathy attributed to TSS.