Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 6, Number 12, December 2015, pages 586-591

Veno-Venous ECMO: An Alternative Strategy for Acute Respiratory Failure After High-Voltage Electrocution. The Utility of Point-of-Care Tests


Figure 1.
Figure 1. TV, PEEP, PaO2/FiO2 and mean airway pressure before ECMO. Description of ventilator parameters and oxygenation before ECMO. TV: tidal volume; PEEP: positive end-expiratory pressure; PaO2/FiO2: ratio of arterial oxygen partial pressure to fractional inspired oxygen.
Figure 2.
Figure 2. Hemodynamic parameters based on PICCO before ECMO. Lactates were stable while GEDI and ELWI increased gradually before ECMO (mean ± SD). GEDI: global end diastolic index; ELWI: extralung water index; CI: cardiac index.
Figure 3.
Figure 3. (A) Antero-posterior chest radiograph before ECMO. *Severe bilateral injuries. (B) Antero-posterior chest radiograph after ECMO. Regular chest XR.
Figure 4.
Figure 4. Three consecutive computed tomography scans show a severe lung injury due to the passage of electrical current. Entrance site was patient’s right arm while and exit site was his left leg.
Figure 5.
Figure 5. Conventional coagulation tests, ROTEM and MULTIPLATE during ECMO and surgery. From left to right: ↓, on PBD 5, the patient was placed on ECMO. ↓, on PBD 12, he went to OR. ↓, on PBD 22, he was decannulated. Strong correlations between MCF, CFT, ACT and aPTT. Fibrinogen was normal. TRAP test value decreased especially after surgery as well as platelet count. ECMO: extracorporeal membrane oxygenator; ACT: activated clotting time; OR: operative room; aPTT: activated partial thromboplastin time; MCF: maximum clot firmness; CFT: clot formation time; INTEM: intrinsic elastometry; TRAP: thrombin receptor activating peptide-6.