Daria Fomina, Russian Federation
Clinical State Hospital #52 State Center of Allergy and ImmunologyPresenter of 1 Presentation
SEVERE COMORBIDITY COMPLICATIONS OF CVID FOLLOWED BY ACUTE RESPIRATORY FAILURE AND DEPRESSED CARDIAL FUNCTION SUCCESSFULLY MANAGED USING A-V ECMO. CLINICAL PRESENTATION.
Abstract
Background and Aims
There is no data describing the usage of ECMO in PubMed, MEDLINE in patients suffering from CVID and respiratory failure, as as a complication, who underwent ECMO-technik support. One of the main contradictions of ECMO use is immunosuppression. We share a clinical case with severe comorbidity complications of CVID followed with acute respiratory failure and depressed cardial function successfully managed using ECMO. The main reason of developing disease severe manifestation was 2 years-long break in replacement therapy with immunoglobulin and such unprecedented incompliance was explained by “religion” family views.
Methods
Multidiciplinary comission's concluded that the AV- ECMO treatment was the only option to be used in life-threatening condition in a patinet with CVID, despite the contraindications, when all less invasive methods of treatment failed. Individualised titration of the replacement therary with Ig has been taking place in all the time points of procedure, due to unpredicted Ig- level varaibility.
Results
13 days on ECMO was an option for saving time for complex antibacterial effort to succseed. A 26-year patient overcame the septick shok and afterwords sucsessfuly decanulated. The serum level of IgG was ruined at the initiative staged of swiching to ECMO , and was corrected by flexible high dose replacement scheme, individualy adapted to the demands of the condition. 
Conclusions
We describe the first adult case with bilateral pneumonia, pansinusitis, and myocarditis in the frame of CVID complications. . The outcome was a healthy patient without sequelaes. This case underlines the necessity of a close interdisciplinary cooperation.
