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VOLUME 23 , ISSUE 4 ( April, 2019 ) > List of Articles

CASE REPORT

Posterior Reversible Encephalopathy Syndrome in a Patient of Sepsis-induced Cardiomyopathy, Successfully Managed with Intra-aortic Balloon Pump

Anudeep Saxena, Vivek Bhargava, Aditya Shreya, Anshul Patodia

Keywords : Intra-aortic balloon pump, Posterior reversible encephalopathy syndrome, Septic cardiomyopathy

Citation Information : Saxena A, Bhargava V, Shreya A, Patodia A. Posterior Reversible Encephalopathy Syndrome in a Patient of Sepsis-induced Cardiomyopathy, Successfully Managed with Intra-aortic Balloon Pump. Indian J Crit Care Med 2019; 23 (4):188-190.

DOI: 10.5005/jp-journals-10071-23152

License: CC BY-NC 4.0

Published Online: 01-03-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

In patients with septic shock refractory to pharmacological agents, mechanical devices have been used successfully, although the reports are scarce. We report a case of septic shock where intra-aortic balloon pump (IABP) initiation leads to drastic improvement and survival from severe septic cardiomyopathy when conventional therapy was not effective. A 19-year-old male patient underwent surgery for adenocarcinoma descending colon. On day 8 he was reoperated for anastomotic leak and developed severe cardiomyopathy associated with septic shock, postoperatively. When he was in a vicious cycle of refractory hypotension, metabolic acidosis and severe cardiomyopathy, IABP was instituted along with other management for septic shock. Over next 3 days patient's hemodynamics improved and IABP was weaned off. While recovering from shock he developed posterior reversible encephalopathy syndrome which was promptly managed. This case report emphasizes on early institution of IABP in case of severe left ventricular dysfunction in septic shock.


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  1. Sato R, Nasu M. A review of sepsis-induced cardiomyopathy. J Intensive Care 2015;3:48.
  2. Vieillard-Baron A, Caille V, et al. Actual incidence of global left ventricular hypokinesia in adult septic shock. Crit Care Med 2008;36:1701.1706.
  3. Nakamura K, Doi K, et al. Endotoxin adsorption by polymyxin B column or intra-aortic balloon pumping use for severe septic cardiomyopathy. Am J Emerg Med 2013;31:893. e1.3.
  4. Hiromi T, Toida C, et al. Two cases with intra-aortic balloon pumping use for severe septic cardiomyopathy. Acute Med Surg 2017;4:446.450.
  5. Ogunbayo G, Olorunfemi O, et al. Outcomes of intra-aortic balloon pump use in myocarditis complicated by cardiogenic shock. J Am Coll Cardiol 2017;69:860.
  6. McKinney AM, Short J, et al. Posterior reversible encephalopathy syndrome: incidence of atypical regions of involvement and imaging findings. Am J Roentgenol 2007;189:904.912.
  7. Bartynski WS, Boardman JF, et al. Posterior reversible encephalopathy syndrome in infection, sepsis, and shock. Am J Neuroradiol 2006;27:2179.2190.
  8. Munford RS. Sepsis, severe sepsis, and septic shock. In: Mandell GL, Bennett JE, Dolin R (Eds). Principles and Practice of Infectious Disease. Philadelphia: Elsevier; 2005. pp. 906.926.
  9. Symeonides S, Balk RA. Nitric oxide in the pathogenesis of sepsis. Infect Dis Clin North Am 1999;13:449.463, x.
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