Venovenous extracorporeal membrane oxygenation (VV ECMO) in community-acquired pneumonia caused by Klebsiella pneumoniae. What went wrong?

Krystian Adrian Ślusarz, Paulina Kurdyś, Patrycja Łanowy, Miłosz Bichalski, Bartosz Bijak, Ewa Trejnowska

Abstract


Despite the progress that has been made in the field of medicine, severe hypoxic respiratory failure due to pneumonia has significant mortality. The etiology of pneumonia can be very different but possible complications include sepsis and acute respiratory distress syndrome (ARDS), resulting in patient’s increased risk of death. Severe respiratory failure in the course of ARDS, which does not respond to conventional therapy, is an indication for the implementation of venovenous extracorporeal membrane oxygenation support (VV ECMO). However, even with the use of targeted antibiotic therapy and advanced methods of extracorporeal life support, successful outcomes are not achieved. The location of the site of infection and the administration of targeted antibiotic therapy seem obvious to the patient's prognosis. Antimicrobial therapy can only succeed if a few basic conditions are met. First of all, the right antibiotic should be used, given in the effective dose and as soon as possible after the onset of septic symptoms. In addition, the possibility of penetration of the active substance to the place affected by the inflammatory process also determines the probability of success of the therapy. This article presents a case report of Klebsiella pneumonia in a 38-year-old man and briefly discusses the challenges of modern medicine. In this case, the treatment was not successful, despite the known ethology, use of the targeted antibiotic therapy and advanced methods of extracorporeal life support. Further researches are needed to help improve treatment outcomes in this group, critically ill patients.

Keywords


pneumonia; sepsis; acute respiratory distress syndrome; extracorporeal membrane oxygenation

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References


Roguin A. Rene Theophile Hyacinthe Laënnec (1781-1826): The man behind the stethoscope. Clinical Medicine & Research. 2006;4(3):230–235.

Heffron R. Pneumonia, with special reference to pneumococcus lobar pneumonia. Cambridge, MA: Harvard University Press, 1939.

Rekomendacje postępowania w pozaszpitalnych zakażeniach układu oddechowego 2016. Available at: http://antybiotyki.edu.pl/wp-content/uploads/Rekomendacje/Rekomendacje2016.pdf.

Guo S, Xu J, Wei Y, Xu J, Li Y, Xue R. Clinical and molecular characteristics of Klebsiella pneumoniae ventilator-associated pneumonia in mainland China. BMC Infectious Diseases. 2016;16(1):1–7.

EUCAST Guidance Documents. Available at: http://www.eucast.org/ast_of_bacteria/guidance_documents/.

Martin RM, Bachman MA. Colonization, Infection, and the Accessory Genome of Klebsiella pneumoniae. Frontiers in Cellular and Infection Microbiology. 2018;8(January):1–15.

Blin C, Passet V, Touchon M, Rocha EPC, Brisse S. Metabolic diversity of the emerging pathogenic lineages of Klebsiella pneumoniae. Environmental Microbiology. 2017;19(5):1881–1898.

De Pascale G, Bello G, Tumbarello M, Antonelli M. Severe pneumonia in intensive care: cause, diagnosis, treatment and management: A review of the literature. Current Opinion in Pulmonary Medicine. 2012;18(3):213–221.

Spalding MC, Cripps MW, Minshall CT. Ventilator-Associated Pneumonia: New Definitions. Critical Care Clinics. 2017;33(2):277–292.

Kalanuria AA, Ziai W, Mirski M. Ventilator-associated pneumonia in the ICU. Critical Care. 2014;18(2):208.

Raro OHF, Gallo SW, Ferreira CAS, Oliveira SD. Carbapenem-resistant Acinetobacter baumannii contamination in an intensive care unit. Revista da Sociedade Brasileira de Medicina Tropical. 2017;50(2):167–172.

Antunes LC, Visca P, Towner KJ. Acinetobacter baumannii: evolution of a global pathogen. Pathogens and Disease. 2014;71(3):292–301.

Lango R, Szkulmowski Z, Maciejewski D, Kusza K. Protokół zastosowania pozaustrojowej oksygenacji krwi (ECMO) w leczeniu ostrej niewydolności oddechowej. Anestezjologia Intensywna Terapia. 2009;41(3):170-175.

Prina E, Ranzani OT, Torres A. Community-acquired pneumonia. Lancet. 2015;386(9998):1097-108.

European Centre for Disease Prevention and Control. Antimicrobial resistance surveillance in Europe 2012. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net). Stockholm: ECDC; 2013.

European Centre for Disease Prevention and Control. Antimicrobial resistance surveillance in Europe 2015. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net). Stockholm: ECDC; 2017.

Joukhadar C, Frossard M, Mayer BX, Brunner M, Klein N, Siostrzonek P, Eichler HG, Müller M. Impaired target site penetration of beta-lactams may account for therapeutic failure in patients with septic shock. Critical Care Medicine. 2001;29:385–391.

Pea F. Plasma Pharmacokinetics of Antimicrobial Agents in Critically Ill Patients. Current Clinical Pharmacology. 2013;8:5-12.




DOI: http://dx.doi.org/10.5281/zenodo.3407541

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