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Prolonged Pediatric Extracorporeal Membrane Oxygenation Support with Cardiopulmonary Failure in Juvenile
Maris Bartkevics1, Bert Hennig2, Tayfun Gungor3
1Center for Congenital Heart Disease, Department of Cardiovascular Surgery, Inselspital University Hospital, Bern University, Bern, Switzerland.
Insights
Extracorporeal membrane oxygenation (ECMO) can be a life-saving treatment for children with juvenile myelomonocytic leukemia (JMML) experiencing cardiopulmonary failure and septic shock. This case highlights ECMO
Area of Science:
- Pediatric Hematology Oncology
- Critical Care Medicine
- Cardiopulmonary Support
Background:
- Juvenile myelomonocytic leukemia (JMML) poses significant risks for pediatric patients, including cardiopulmonary complications.
- Septic shock in malignancy increases the risk of early mortality due to pulmonary issues like leukostasis and systemic inflammation.
- The use of extracorporeal membrane oxygenation (ECMO) in septic pediatric cancer patients remains a topic of debate.
Abstract:
We report a case of a child survival after extracorporeal membrane oxygenation (ECMO) support of 25 days for cardiopulmonary failure and septic shock in the context of juvenile myelomonocytic leukemia (JMML). ECMO support is still a matter of debate for the management of septic patients with malignancy. However, these patients are at increased risk for early death secondary to pulmonary complications due to leukostasis, direct pulmonary infiltration with WBC, and systemic inflammatory response syndrome following malignant cell lysis. Despite the high risk of complications, ECMO support must be discussed as part of management, providing better outcome in this group of patients.
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