Noncardiogenic pulmonary edema induced by a molecular adsorbent recirculating system: Case report

Cataido Doria, Lucio Mandalà, Victor L. Scott, Ignazio R. Marino, Salvatore Gruttadauria, Roberto Miraglia, Claudio H. Vitale, Jan Smith

Research output: Contribution to journalArticle

Abstract

Noncardiogenic pulmonary edema is a well-recognized manifestation of acute lung injury which has been related, among others, to blood or blood-product transfusion, intravenous contrast injection, air embolism, and drug ingestion. We describe two cases of noncardiogenic pulmonary edema after use of a molecular adsorbent recirculating system, a cell-free dialysis technique. Patients in this series presented at our institution to be evaluated for liver transplantation. Subsequently, they developed an indication for the molecular adsorbent recirculating system. Two patients of 30 (6.6%) treated with the molecular adsorbent recirculating system for acute-on-chronic liver failure and intractable pruritus had normal chest X-rays before treatment and developed severe pulmonary edema, in the absence of cardiogenic causes, following use of the molecular adsorbent recirculating system. For each patient we reviewed the history of blood or blood-product transfusion, echocardiograms if available, daily chest X-rays, and when available pre- and postmolecular adsorbent recirculating systemic blood pressure, central venous pressure, pulmonary arterial pressures, cardiac output, cardiac index, systemic vascular resistance index, and arterial blood gas. Our data suggest that the molecular adsorbent recirculating system may cause noncardiogenic pulmonary edema, possibly by an immune-mediated mechanism.

Original languageEnglish
Pages (from-to)282-285
Number of pages4
JournalJournal of Artificial Organs
Volume6
Issue number4
DOIs
Publication statusPublished - 2003

Keywords

  • Albumin
  • Artificial liver
  • Cytokine
  • Dialysis
  • Hepatitis
  • Lung edema

ASJC Scopus subject areas

  • Biophysics

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