Document Detail


Abciximab-induced alveolar hemorrhage treated with rescue extracorporeal membranous oxygenation.
MedLine Citation:
PMID:  25381962     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We describe a case of a 75 year-old woman presenting emergently with an anterior S-T elevation myocardial infarction that deteriorated into ventricular fibrillation requiring prompt resuscitation, resulting in cardiogenic shock. Emergency primary percutaneous coronary intervention of the left anterior descending coronary artery with adjunctive abciximab and heparin resulted in adequate coronary flow, and intraaortic balloon pump was used to support hemodynamics. Within 12 hours of intervention, she developed acute respiratory distress with four-quadrant opacification of lung fields, difficulty with oxygenation, and hypotension. Emergency bronchoscopy revealed diffuse erythematous proximal airways with bloody secretions bilaterally confirming diffuse alveolar hemorrhage. An emergency veno-arterial extracorporeal membranous oxygenation (ECMO) circuit was placed at the bedside, acutely improving oxygenation and hemodynamics. She survived the hospitalization with multiple complications related to access site and prolonged intensive care unit stay, was discharged to acute rehabilitation. She is currently thriving 16 months post-procedure. This case highlights the use of ECMO in the often-fatal condition of diffuse alveolar hemorrhage related to glycoprotein inhibitor use. © 2014 Wiley Periodicals, Inc.
Authors:
Andrew W Choi; John E A Blair; James D Flaherty
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-8
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-10     Completed Date:  -     Revised Date:  2014-11-11    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Wiley Periodicals, Inc., a Wiley company.
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