Síndrome inflamatorio multisistémico pediátrico en paciente con oxigenación por membrana extracorpórea, reporte de un caso

Abstract

Pediatric multisystem inflammatory syndrome temporally associated with COVID-19 is a rare presentation of SARS-CoV-2 infection. Its most common manifestation is cardiogenic shock, with a high percentage of patients requiring vasoactive and inotropic support.

Occasionally, the myocardial dysfunction can be severe enough to result in death. Therapies such as extracorporeal membrane oxygenation (ECMO) provide a transient support option for recovery; however, it is an underutilized tool.

In this article, we present the case of an adolescent who initially presented with gastrointestinal symptoms and fever, who subsequently developed refractory cardiogenic shock attributed to a systemic inflammatory syndrome associated with COVID-19. The presence of SARS-CoV-2 was identified through tracheal aspirate, and due to hemodynamic instability, the patient received ECMO therapy along with steroid medications, immunomodulators, and inotropes. After one week, the patient recovered ventricular function with a favorable outcome.

In conclusion, ECMO therapy in pediatric patients with systemic inflammatory syndrome associated with COVID-19 may contribute to improved survival. However, the low utilization of this therapy and limited reporting in the literature lead to deficiencies in the evidence supporting its implementation.