Abstract:
OBJECTIVES:We report the case of a 28-year-old patient with systemic lupus erythematosus (SLE) with rapid onset of dyspnea and hemoptysis found to have diffuse alveolar hemorrhage (DAH) with refractory hypoxemia successfully treated with venovenous extracorporeal membrane oxygenation (ECMO). The discussion includes clinical presentation, diagnosis, management, outcome, and a review of the available adult literature on the use of ECMO in patients with DAH. DESIGN:Case report. SETTING:Froedtert Hospital and the Medical College of Wisconsin. DATA SOURCES:Data were collected from the patient's electronic medical record and the hospital radiology database. CONCLUSIONS:Diffuse alveolar hemorrhage secondary to SLE is quite rare. The adult literature on the utilization of ECMO for DAH is limited mostly to antineutrophil cytoplasmic antibody (ANCA)-associated alveolar hemorrhage and a few reports of nonvasculitis DAH. Bleeding has been a contraindication to ECMO due to the need for systemic anticoagulation. Our case, along with a review of the literature, indicates that ECMO with anticoagulation can be safely utilized in patients with DAH. To our knowledge, this is the first reported adult case of DAH due to SLE successfully treated with ECMO.
journal_name
J Intensive Care Medjournal_title
Journal of intensive care medicineauthors
Patel JJ,Lipchik RJdoi
10.1177/0885066612464335subject
Has Abstractpub_date
2014-03-01 00:00:00pages
104-9issue
2eissn
0885-0666issn
1525-1489pii
0885066612464335journal_volume
29pub_type
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