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J Pediatr Intensive Care 2020; 09(04): 299-303
DOI: 10.1055/s-0040-1709499
Case Report

Extracorporeal Cardiopulmonary Resuscitation in Acute Fulminant Myocarditis: A Case Report and Review of the Literature

Jesus Andres Rodriguez-Coronado
1   Department of Pediatric Intensive Care, Hospital Christus Muguerza Alta Especialidad, Nuevo Leon, México
,
Jesus Arturo Saldivar-Martinez
1   Department of Pediatric Intensive Care, Hospital Christus Muguerza Alta Especialidad, Nuevo Leon, México
,
Rene Daniel Gomez-Gutierrez
1   Department of Pediatric Intensive Care, Hospital Christus Muguerza Alta Especialidad, Nuevo Leon, México
,
Guillermo Quezada-Valenzuela
2   Department of Cardiovascular Surgery, Hospital Christus Muguerza Alta Especialidad, Nuevo Leon, México
,
Maria Veronica Contreras-Cepeda
2   Department of Cardiovascular Surgery, Hospital Christus Muguerza Alta Especialidad, Nuevo Leon, México
,
Ramon Gerardo Sanchez-Cortes
3   Department of Pediatric Cardiology, Hospital Christus Muguerza Alta Especialidad, Nuevo Leon, México
,
Miguel A. Paz-Gonzalez
4   Department of Pathology, Hospital Christus Muguerza Alta Especialidad, Nuevo Leon, México
,
Mario Alberto Castillo-Treviño
1   Department of Pediatric Intensive Care, Hospital Christus Muguerza Alta Especialidad, Nuevo Leon, México
,
Enrique G. Villarreal 
5   Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico
› Author Affiliations Funding None.
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Abstract

Fulminant myocarditis is a life-threatening fast progressive condition. We present a 7-year-old female patient admitted with a diagnosis of acute myocarditis with a rapidly progressive cardiac dysfunction despite conventional vasoactive and inotropic treatment. The patient presented with ventricular fibrillation and subsequent cardiac arrest. Cardiopulmonary resuscitation (CPR) was performed during 105 minutes before extracorporeal membrane oxygenation (ECMO) cannulation was performed. Effective hemodynamic function was obtained, and ECMO was weaned after 7 days, without neurological complications. There are not established extracorporeal cardiopulmonary resuscitation (eCPR) treatment criteria, and some international guidelines consider up to 100 minutes of “low flow” phase as a time limit to start the support. Some mortality risk factors for ECMO treatment mortality are female gender, renal failure, and arrhythmias. Pre-ECMO good prognostic factors are high levels of pH and blood lactate.

Keywords

extracorporeal membrane oxygenation - myocarditis - cardiopulmonary resuscitation - risk factor - prognostic factors


Publication History

Received: 28 December 2019

Accepted: 04 March 2020

Article published online:
17 April 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

 

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