Venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock induced by adrenal lesions: a case report and review of the literature

Abstract BackgroundMost adrenal disorders have an insidious onset and are not severe. Only a minority of adrenal lesions can lead to life-threatening cardiovascular crisis. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an extracorporeal life support technology that can partially replace human cardiopulmonary function. To date, many case reports have indicated that this technology can temporarily help patients survive critical condition and to achieve a good prognosis. Case presentation : A 27-year-old male patient presented to the emergency department with sudden dyspnoea and haemoptysis. Pulmonary oedema, cardiogenic shock and cardiac arrest occurred immediately after admission, prompting VA-ECMO treatment. After the patient’s haemodynamics were stabilized, multiple endocrine neoplasia type 2 (MEN2) was detected via laboratory tests and imaging examination. After the withdrawal of VA-ECMO support, surgical resection of the lesions was performed, and a good prognosis was achieved.ConclusionVA-ECMO can be used as an emergency treatment for refractory cardiogenic shock caused by adrenal lesions. However, a large number of prospective studies are still needed to confirm its safety and efficacy and to clarify the timing of initiation and assessment of patient prognosis.