Veno-arterial extracorporeal membrane oxygenation in a patient with septic cardiomyopathy induced by severe community-acquired pneumonia due to Acinetobacter baumannii: A case report
Abstract
RATIONALE: Community-acquired pneumonia due to Acinetobacter baumannii (CAP-AB) is uncommon; however, its mortality is extremely high because of severe pneumonia, septic shock, and multiple organ dysfunction syndrome including septic cardiomyopathy and cardiogenic shock. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO), an important component of treatment in the early stage of septic cardiomyopathy can affect the prognosis of similar patients.
PATIENT CONCERNS: A 65-year-old man presented to the fever clinic with fever, cough, and stuffiness for 1 day. On admission, he manifested hypoxemia and hypotension, and chest computed tomography showed pneumonia, and Acinetobacter baumannii (AB) was positive in bronchoalveolar lavage fluid tested by metagenomic next-generation sequencing (mNGS).
DIAGNOSES: Community-acquired pneumonia (CAP), respiratory failure, septic shock, septic cardiomyopathy, and cardiogenic shock.
INTERVENTIONS: As the diagnosis of septic shock, septic cardiomyopathy and cardiogenic shock induced by CAP-AB and respiratory failure were made, cefoperazone/sulbactam 3 g q8h, moxifloxacin 400 mg qd, inotropes and vasopressors and mechanical ventilation were initiated. However, although global end diastolic volume index was 744 mL/m2, hypotension and tachycardia remained, the left ventricular ejection fraction was 30%, and circulatory failure (cardiogenic shock) did not improve. Hence, VA-ECMO was applied to assist circulation on the day of admission due…
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