Extracorporeal cardiopulmonary resuscitation for sudden cardiac arrest induced by septic shock-related adrenal crisis

Extracorporeal cardiopulmonary resuscitation is being increasingly used to treat refractory in-hospital cardiac arrest (IHCA). Etiologies of IHCA may differ from etiologies of out-of-hospital cardiac arrest. We report a case of a 50-year-old man who was admitted to a local hospital, presenting with...

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Main Authors: Martin Pažitný, Matúš Maruniak, Martin Ilenin, Dušan Rybár, Tomáš Grendel
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-07-01
Series:Turkish Journal of Emergency Medicine
Subjects:
Online Access:https://journals.lww.com/10.4103/tjem.tjem_213_24
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author Martin Pažitný
Matúš Maruniak
Martin Ilenin
Dušan Rybár
Tomáš Grendel
author_facet Martin Pažitný
Matúš Maruniak
Martin Ilenin
Dušan Rybár
Tomáš Grendel
author_sort Martin Pažitný
collection DOAJ
description Extracorporeal cardiopulmonary resuscitation is being increasingly used to treat refractory in-hospital cardiac arrest (IHCA). Etiologies of IHCA may differ from etiologies of out-of-hospital cardiac arrest. We report a case of a 50-year-old man who was admitted to a local hospital, presenting with drowsiness, hypotension, and severe metabolic acidosis. After being transferred to our tertiary center, he quickly progressed to cardiac arrest and required extracorporeal cardiopulmonary resuscitation (eCPR) with veno-arterial extracorporeal membrane oxygenation (VA ECMO). Initially, due to high levels of inflammatory markers, sepsis became the most probable diagnosis. The patient responded well to antibiotics and supplemental corticosteroid therapy. Subsequent investigation revealed sepsis-induced absence of cortisol based on previously unknown hypopituitarism. Following corticoid administration, rapid myocardial recovery occurred with successful ECMO weaning. The patient was discharged from the ICU after 13 days with a favorable neurological outcome. Therefore, VA ECMO seems to be a feasible method to provide a bridge to recovery in patients with sudden hemodynamic collapse due to an adrenal crisis.
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institution Kabale University
issn 2452-2473
language English
publishDate 2025-07-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Turkish Journal of Emergency Medicine
spelling doaj-art-8316e6663fb448aa81dcfbff3e4d8ebb2025-08-21T12:35:40ZengWolters Kluwer Medknow PublicationsTurkish Journal of Emergency Medicine2452-24732025-07-0125324224510.4103/tjem.tjem_213_24Extracorporeal cardiopulmonary resuscitation for sudden cardiac arrest induced by septic shock-related adrenal crisisMartin PažitnýMatúš MaruniakMartin IleninDušan RybárTomáš GrendelExtracorporeal cardiopulmonary resuscitation is being increasingly used to treat refractory in-hospital cardiac arrest (IHCA). Etiologies of IHCA may differ from etiologies of out-of-hospital cardiac arrest. We report a case of a 50-year-old man who was admitted to a local hospital, presenting with drowsiness, hypotension, and severe metabolic acidosis. After being transferred to our tertiary center, he quickly progressed to cardiac arrest and required extracorporeal cardiopulmonary resuscitation (eCPR) with veno-arterial extracorporeal membrane oxygenation (VA ECMO). Initially, due to high levels of inflammatory markers, sepsis became the most probable diagnosis. The patient responded well to antibiotics and supplemental corticosteroid therapy. Subsequent investigation revealed sepsis-induced absence of cortisol based on previously unknown hypopituitarism. Following corticoid administration, rapid myocardial recovery occurred with successful ECMO weaning. The patient was discharged from the ICU after 13 days with a favorable neurological outcome. Therefore, VA ECMO seems to be a feasible method to provide a bridge to recovery in patients with sudden hemodynamic collapse due to an adrenal crisis.https://journals.lww.com/10.4103/tjem.tjem_213_24adrenal crisisextracorporeal cardiopulmonary resuscitationseptic shockveno-arterial extracorporeal membrane oxygenation
spellingShingle Martin Pažitný
Matúš Maruniak
Martin Ilenin
Dušan Rybár
Tomáš Grendel
Extracorporeal cardiopulmonary resuscitation for sudden cardiac arrest induced by septic shock-related adrenal crisis
Turkish Journal of Emergency Medicine
adrenal crisis
extracorporeal cardiopulmonary resuscitation
septic shock
veno-arterial extracorporeal membrane oxygenation
title Extracorporeal cardiopulmonary resuscitation for sudden cardiac arrest induced by septic shock-related adrenal crisis
title_full Extracorporeal cardiopulmonary resuscitation for sudden cardiac arrest induced by septic shock-related adrenal crisis
title_fullStr Extracorporeal cardiopulmonary resuscitation for sudden cardiac arrest induced by septic shock-related adrenal crisis
title_full_unstemmed Extracorporeal cardiopulmonary resuscitation for sudden cardiac arrest induced by septic shock-related adrenal crisis
title_short Extracorporeal cardiopulmonary resuscitation for sudden cardiac arrest induced by septic shock-related adrenal crisis
title_sort extracorporeal cardiopulmonary resuscitation for sudden cardiac arrest induced by septic shock related adrenal crisis
topic adrenal crisis
extracorporeal cardiopulmonary resuscitation
septic shock
veno-arterial extracorporeal membrane oxygenation
url https://journals.lww.com/10.4103/tjem.tjem_213_24
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AT matusmaruniak extracorporealcardiopulmonaryresuscitationforsuddencardiacarrestinducedbysepticshockrelatedadrenalcrisis
AT martinilenin extracorporealcardiopulmonaryresuscitationforsuddencardiacarrestinducedbysepticshockrelatedadrenalcrisis
AT dusanrybar extracorporealcardiopulmonaryresuscitationforsuddencardiacarrestinducedbysepticshockrelatedadrenalcrisis
AT tomasgrendel extracorporealcardiopulmonaryresuscitationforsuddencardiacarrestinducedbysepticshockrelatedadrenalcrisis