RESUMO
Adenoviral pneumonia can cause significant pulmonary morbidity leading to extracorporeal membrane oxygenation (ECMO) rescue. Reported survival of adenoviral pneumonia requiring ECMO has been poor, and prolonged time on ECMO is associated with increased mortality. We present 2 pediatric cases of adenoviral pneumonia in patients who survived after greater than 30 days on ECMO and review the Extracorporeal Life Support Organization (ELSO) registry to describe the collective experience of children with viral pneumonia requiring prolonged ECMO. Although survival has improved over the past decade for pediatric adenoviral pneumonia, the ELSO database previously has had no surviving children reported with a primary diagnosis of adenovirus after more than 4 weeks on ECMO. Our experience suggests that there may be use for prolonged ECMO support in children despite severe adenoviral pneumonia.
Assuntos
Infecções por Adenovirus Humanos/terapia , Oxigenação por Membrana Extracorpórea/métodos , Pneumonia Viral/terapia , Infecções por Adenovirus Humanos/diagnóstico , Antibacterianos/uso terapêutico , Pré-Escolar , Oxigenação por Membrana Extracorpórea/efeitos adversos , Feminino , Seguimentos , Humanos , Lactente , Pneumonia Viral/diagnóstico , Medição de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Desmame do Respirador/métodosRESUMO
Management of thoracopagus conjoined twins is predominantly determined by the associated complex cardiovascular abnormalities seen in the majority of these cases. Magnetic resonance imaging (MRI), including three-dimensional contrast-enhanced magnetic resonance angiography (MRA) provides a useful complement to conventional cardiac echocardiography or catheterization for detailed evaluation of the extra-cardiac anatomy. We report a pair of female thoracopagus conjoined twins with a shared six-chambered heart. The MRA findings are highlighted.
