Lab Med Online.  2021 Jan;11(1):64-68. 10.47429/lmo.2021.11.1.64.

Simultaneous Extracorporeal Membrane Oxygenation, Renal Replacement Therapy, and Plasma Exchange for Thrombocytopenia-Associated Multiple Organ Failure

• Lee H
• Yoo J
• Lee J
• Jekarl DW
• Kim M
• Kim Y

• KMID: 2525783
• DOI: http://doi.org/10.47429/lmo.2021.11.1.64

Abstract

Thrombocytopenia-associated multiple organ failure (TAMOF) is a distinct type of sepsis related to thrombocytopenia, microangiopathic hemolysis, and multiple organ failure. TAMOF belongs to a spectrum of syndromes related to disseminated intravascular coagulopathy, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome. Treatment modalities for TAMOF include therapeutic plasma exchange along with other extracorporeal organ support. To the best of our knowledge, we report the first case of triple-modality treatment for TAMOF in Korea, which involved extracorporeal membrane oxygenation, continuous renal replacement therapy, and therapeutic plasma exchange in a patient with TAMOF.

Keyword

Multiple organ failure; Thrombocytopenia; Thrombotic microangiopathies; Plasmapheresis; Plasma exchange; Extracorporeal membrane oxygenation; Continuous renal replacement therapy

Figure

• 

  Fig. 1 Summary of disease progression in the TAMOF patient. Abbreviations: ECMO, extracorporeal membrane oxygenation; CRRT, continuous renal replacement therapy; TPE, therapeutic plasma exchange; P:F ratio, PaO2:FiO2 ratio; HD, hospital day; SOFA, sequential organ failure assessment; NG, no growth; TAMOF, thrombocytopenia-associated multiple organ failure.

• 

  Fig. 2 Triple-modality circuit of ECMO, CRRT, and TPE. Abbreviations: ECV, extracorporeal volume; ECMO, extracorporeal membrane oxygenation; CRRT, continuous renal replacement therapy; TPE, therapeutic plasma exchange.

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