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J Pediatr Intensive Care 2019; 08(03): 181-186
DOI: 10.1055/s-0039-1679904
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Extracorporeal Membrane Oxygenation for Diffuse Alveolar Hemorrhage Caused by Idiopathic Pulmonary Hemosiderosis: A Case Report and a Review of the Literature

Shotaro Matsumoto 
1   Division of Critical Care Medicine, National Center for Child Health and Development, Setagaya, Tokyo, Japan
,
Satoshi Nakagawa
1   Division of Critical Care Medicine, National Center for Child Health and Development, Setagaya, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

11 October 2018

13 January 2019

Publication Date:
25 February 2019 (online)

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Abstract

Diffuse alveolar hemorrhage (DAH) is a life-threatening condition presenting with hemoptysis, anemia, and diffuse radiographic pulmonary infiltrates; it causes acute respiratory failure. Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of DAH occurring predominantly in children. Bleeding is often considered to be a contraindication for extracorporeal membrane oxygenation (ECMO) due to systemic anticoagulation. We present an 8-year-old girl with DAH caused by IPH. Unfractionated heparin was administered to maintain an activated clotting time of 150 to 180 seconds. The DAH resolved with immunosuppressive therapy, and the patient survived to decannulation. ECMO may be applied as a rescue therapy for DAH even with systemic anticoagulation.

Keywords

extracorporeal membrane oxygenation - diffuse alveolar hemorrhage - idiopathic pulmonary hemosiderosis
 

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