A case of septic shock with cardiac arrest saved by veno-arterial extracorporeal membrane oxygenation (VA-ECMO)

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  • 心停止を呈した敗血症性ショックに対し，VA-ECMOを導入し救命し得た一症例

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<p>Circulatory failure can occur in non-responders to standard treatment for septic shock. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in such cases is, however, controversial. Here, we report a patient who was rescued by VA-ECMO for repeated cardiac arrest following admission to the ICU for suspected septic shock due to a prostatic abscess.</p><p>　The septic shock was treated with endotoxin adsorption therapy (PMX-DHP) and continuous hemodiafiltration. Circulation was maintained by VA-ECMO. An increase in arterial pulse pressure and an improvement in cardiac contractility that were observed on an echocardiogram obtained on the 2nd day of VA-ECMO. Therefore, low-dose dobutamine was commenced. The VA-ECMO was terminated on day 5.</p><p>　In the present case, severe myocardial injury arose as a result of septic shock due to a urinary tract infection, leading to cardiac arrest. Stable circulation was restored by VA-ECMO that allows to treat the underlying infection effectively. Depending on the course of septic shock, infected foci, and underlying diseases, VA-ECMO may be considered an effective option for the treatment of severe circulatory failure.</p>

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