When the #heart gets the #flu: Fulminant #influenza B #myocarditis: A case-series report and review of the literature (J Crit Care, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Crit Care. 2018 Jun 9;47:61-64. doi: 10.1016/j.jcrc.2018.06.001. [Epub ahead of print]

When the heart gets the flu: Fulminant influenza B myocarditis: A case-series report and review of the literature.

Hékimian G1, Jovanovic T2, Bréchot N2, Lebreton G3, Leprince P3, Trouillet JL2, Schmidt M2, Nieszkowska A2, Besset S2, Chastre J2, Combes A2, Luyt CE2.

Author information: 1 Département de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Pierre et Marie Curie (UPMC), Paris, France; Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS_1166-ICAN Institute of Cardiometabolism and Nutrition, Paris, France. Electronic address: guillaume.hekimian@aphp.fr. 2 Département de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Pierre et Marie Curie (UPMC), Paris, France; Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS_1166-ICAN Institute of Cardiometabolism and Nutrition, Paris, France. 3 Département de Chirurgie Cardiaque et Thoracique, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Pierre et Marie Curie (UPMC), Paris, France; Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS_1166-ICAN Institute of Cardiometabolism and Nutrition, Paris, France.

 

Abstract

PURPOSE:

To describe patients with refractory cardiogenic shock related to influenza B virus myocarditis rescued by venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO).

MATERIAL AND METHODS:

Consecutive patients hospitalized in our unit for influenza-associated myocarditis were prospectively included. We also conducted a systematic MEDLINE database literature review through the PubMed search engine, between 1946 and 2017.

RESULTS:

We report the cases of 4 young patients with fulminant myocarditis requiring VA-ECMO for 6 [5-8] days. Influenza B virus was detected in all patients, either in nasopharyngeal sampling or bronchoalveolar lavage fluid. The 4 patients received oseltamivir. Heart function recovery allowed ECMO device removal without cardiac sequelae in all 4 patients. Systematic review retrieved 184 cases of influenza-associated myocarditis, most cases associated with H1N1 type-A infection during the 2009 pandemic. Forty eight cases of influenza myocarditis-associated cardiogenic shock requiring mechanical circulatory support including 3 cases due to influenza B virus were described. Mean duration of mechanical circulatory support was 8.5 ± 6 days and mortality rate was 33%.

CONCLUSIONS:

Influenza myocarditis is a rare but reversible cause of cardiogenic shock amenable to VA-ECMO rescue. Early antiviral therapy and ECMO support should be considered for patients with fulminant myocarditis during an influenza epidemic.

Copyright © 2018. Published by Elsevier Inc.

KEYWORDS: Cardiogenic shock; Extracorporeal membrane oxygenation; Influenza; Mechanical circulatory support; Myocarditis

PMID: 29929152 DOI: 10.1016/j.jcrc.2018.06.001

Keywords: Seasonal Influenza; Influenza B; H1N1pdm09; Acute Myocarditis.

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gimi69

I am an Italian blogger, active since 2005 with main focus on emerging infectious diseases such as avian influenza, SARS, antibiotics resistance, and many other global Health issues. Other fields of interest are: climate change, global warming, geological and biological sciences. My activity consists mainly in collection and analysis of news, public services updates, confronting sources and making decision about what are the 'signals' of an impending crisis (an outbreak, for example). When a signal is detected, I follow traces during the entire course of an event. I started in 2005 my blog ''A TIME'S MEMORY'', now with more than 40,000 posts and 3 millions of web interactions. Subsequently I added an Italian Language blog, then discontinued because of very low traffic and interest. I contributed for seven years to a public forum (FluTrackers.com) in the midst of the Ebola epidemic in West Africa in 2014, I left the site to continue alone my data tracking job.

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