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J Crit Care. 2018 Jun 9;47:61-64. doi: 10.1016/j.jcrc.2018.06.001. [Epub ahead of print]
When the heart gets the flu: Fulminant influenza B myocarditis: A case-series report and review of the literature.
H?kimian G1, Jovanovic T2, Br?chot N2, Lebreton G3, Leprince P3, Trouillet JL2, Schmidt M2, Nieszkowska A2, Besset S2, Chastre J2, Combes A2, Luyt CE2.
Author information
Abstract
PURPOSE:
To describe patients with refractory cardiogenic shock related to influenza B virus myocarditis rescued by venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO).
MATERIAL AND METHODS:
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.
RESULTS:
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%.
CONCLUSIONS:
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.
KEYWORDS:
Cardiogenic shock; Extracorporeal membrane oxygenation; Influenza; Mechanical circulatory support; Myocarditis
PMID: 29929152 DOI: 10.1016/j.jcrc.2018.06.001
When the heart gets the flu: Fulminant influenza B myocarditis: A case-series report and review of the literature.
H?kimian G1, Jovanovic T2, Br?chot N2, Lebreton G3, Leprince P3, Trouillet JL2, Schmidt M2, Nieszkowska A2, Besset S2, Chastre J2, Combes A2, Luyt CE2.
Author information
Abstract
PURPOSE:
To describe patients with refractory cardiogenic shock related to influenza B virus myocarditis rescued by venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO).
MATERIAL AND METHODS:
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.
RESULTS:
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%.
CONCLUSIONS:
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.
KEYWORDS:
Cardiogenic shock; Extracorporeal membrane oxygenation; Influenza; Mechanical circulatory support; Myocarditis
PMID: 29929152 DOI: 10.1016/j.jcrc.2018.06.001