P83 TREATMENT OF ARDS DURING STAPHYLOCOCCAL ENDOCARDITIS WITH EXTRACORPOREAL MEMBRANOUS OXYGENATION (ECMO)

Abstract

ECMO is not common in the treatment of endocarditis complications. A case is presented of complete recovery after staphylococcal endocarditis complicated with ARDS and septic meningitis in a 65-year-old female with no co-morbidities except arterial hypertension. The patient was admitted to the hospital on the third day of fever, malaise and cough. On 5th day of hospitalization she developed respiratory failure and was admitted into ICU. The first echocardiography showed mitral valve endocarditis with moderate mitral regurgitation. Septic meningitis was also found. The next day after the admission into ICU mechanical ventilation started because of the progressing hypoxemia. On the same day, because of the further deterioration, we started ECMO procedure and continued it for the next 48 hours. There were no complications of the ECMO treatment. After the weaning, cardiac surgery was performed because of the progression in the size of vegetation and abscess formation of the mitral annulus. The patient was medically treated with cloxacillin for next 28 days. Sixteen months after admission the patient was completely well, Karnofsky score 100%. This case reports a rapid progression of the staphylococcal sepsis in the patient with no apparent risk factors and shows that initial complex critical care, including ECMO, might significantly improve patients' perspectives for full recovery.