tetano
Editor, Senior Moderator
J Crit Care. 2018 Jun 9;47:61-64. doi: 10.1016/j.jcrc.2018.06.001. [Epub ahead of print]
[h=1]When the heart gets the flu: Fulminant influenza B myocarditis: A case-series report and review of the literature.[/h] H?kimian G[SUP]1[/SUP], Jovanovic T[SUP]2[/SUP], Br?chot N[SUP]2[/SUP], Lebreton G[SUP]3[/SUP], Leprince P[SUP]3[/SUP], Trouillet JL[SUP]2[/SUP], Schmidt M[SUP]2[/SUP], Nieszkowska A[SUP]2[/SUP], Besset S[SUP]2[/SUP], Chastre J[SUP]2[/SUP], Combes A[SUP]2[/SUP], Luyt CE[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]PURPOSE:[/h] To describe patients with refractory cardiogenic shock related to influenza B virus myocarditis rescued by venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO).
[h=4]MATERIAL AND METHODS:[/h] Consecutive patients hospitalized in our unit for influenza-associated myocarditis were prospectively included. We also conducted a systematic MEDLINE database literature review through the PubMed search engine, between 1946 and 2017.
[h=4]RESULTS:[/h] We report the cases of 4 young patients with fulminant myocarditis requiring VA-ECMO for 6 [5-8] days. Influenza B virus was detected in all patients, either in nasopharyngeal sampling or bronchoalveolar lavage fluid. The 4 patients received oseltamivir. Heart function recovery allowed ECMO device removal without cardiac sequelae in all 4 patients. Systematic review retrieved 184 cases of influenza-associated myocarditis, most cases associated with H1N1 type-A infection during the 2009 pandemic. Forty eight cases of influenza myocarditis-associated cardiogenic shock requiring mechanical circulatory support including 3 cases due to influenza B virus were described. Mean duration of mechanical circulatory support was 8.5 ? 6 days and mortality rate was 33%.
[h=4]CONCLUSIONS:[/h] Influenza myocarditis is a rare but reversible cause of cardiogenic shock amenable to VA-ECMO rescue. Early antiviral therapy and ECMO support should be considered for patients with fulminant myocarditis during an influenza epidemic.
Copyright ? 2018. Published by Elsevier Inc.
[h=4]KEYWORDS:[/h] Cardiogenic shock; Extracorporeal membrane oxygenation; Influenza; Mechanical circulatory support; Myocarditis
PMID: 29929152 DOI: 10.1016/j.jcrc.2018.06.001
[h=1]When the heart gets the flu: Fulminant influenza B myocarditis: A case-series report and review of the literature.[/h] H?kimian G[SUP]1[/SUP], Jovanovic T[SUP]2[/SUP], Br?chot N[SUP]2[/SUP], Lebreton G[SUP]3[/SUP], Leprince P[SUP]3[/SUP], Trouillet JL[SUP]2[/SUP], Schmidt M[SUP]2[/SUP], Nieszkowska A[SUP]2[/SUP], Besset S[SUP]2[/SUP], Chastre J[SUP]2[/SUP], Combes A[SUP]2[/SUP], Luyt CE[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]PURPOSE:[/h] To describe patients with refractory cardiogenic shock related to influenza B virus myocarditis rescued by venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO).
[h=4]MATERIAL AND METHODS:[/h] Consecutive patients hospitalized in our unit for influenza-associated myocarditis were prospectively included. We also conducted a systematic MEDLINE database literature review through the PubMed search engine, between 1946 and 2017.
[h=4]RESULTS:[/h] We report the cases of 4 young patients with fulminant myocarditis requiring VA-ECMO for 6 [5-8] days. Influenza B virus was detected in all patients, either in nasopharyngeal sampling or bronchoalveolar lavage fluid. The 4 patients received oseltamivir. Heart function recovery allowed ECMO device removal without cardiac sequelae in all 4 patients. Systematic review retrieved 184 cases of influenza-associated myocarditis, most cases associated with H1N1 type-A infection during the 2009 pandemic. Forty eight cases of influenza myocarditis-associated cardiogenic shock requiring mechanical circulatory support including 3 cases due to influenza B virus were described. Mean duration of mechanical circulatory support was 8.5 ? 6 days and mortality rate was 33%.
[h=4]CONCLUSIONS:[/h] Influenza myocarditis is a rare but reversible cause of cardiogenic shock amenable to VA-ECMO rescue. Early antiviral therapy and ECMO support should be considered for patients with fulminant myocarditis during an influenza epidemic.
Copyright ? 2018. Published by Elsevier Inc.
[h=4]KEYWORDS:[/h] Cardiogenic shock; Extracorporeal membrane oxygenation; Influenza; Mechanical circulatory support; Myocarditis
PMID: 29929152 DOI: 10.1016/j.jcrc.2018.06.001