inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 110.35401/2500-0268-2019-15-3-44-48inovmed-210Research ArticleCЛУЧАЙ ИЗ ПРАКТИКИСASE REPORTSРоль экстракорпоральной мембранной оксигенации в терапии легионеллезной пневмонии у пациентки с волосатоклеточным лейкозомImportance of extracorporeal membrane oxygenation (ECMO) in therapy for legionella pneumonia in patient with hairy-cell leucosishttps://orcid.org/0000-0002-7211-1071СкопецА. А.SkopetsA. A.

Скопец Александр Алексеевич – к. м. н., заведующий отделением анестезиологии и реанимации № 2

350086, Краснодар, ул. 1 Мая, 167

Skopets Alexander A. – Cand. of Sci. (Med.), head of anesthesiology and resuscitation unit no. 2

350086, Krasnodar, 167, 1st May str.

alskop1961@mail.ruhttps://orcid.org/0000-0002-0599-6076КорниловИ. А.KornilovI. A.

Корнилов Игорь Анатольевич – старший научный сотрудник центра анестезиологии и реанимации

Новосибирск

Kornilov Igor A. – senior research assistant of the anesthesiology and resuscitation center

Novosibirsk

i_kor-nilov@nricp.ruhttps://orcid.org/0000-0002-1232-7110АфонинЕ. С.AfoninE. S.

Афонин Евгений Сергеевич – врач отделения анестезиологии и реанимации № 2

Краснодар

Afonin Evgeniy S. – physician of anesthesiology and resuscitation unit no. 2

Krasnodar

joni0208@mail.ruНаучно-исследовательский институт – Краевая клиническая больница № 1 им. проф. С.В. Очаповского Министерства здравоохранения Краснодарского краяРоссияScientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1Russian FederationНациональный медицинский исследовательский центр имени академика Е.Н. Мешалкина Министерства здравоохранения РФРоссияMeshalkin National Medical Research CenterRussian Federation201930092019034448Copyright © Скопец А.А., Корнилов И.А., Афонин Е.С., 20192019Скопец А.А., Корнилов И.А., Афонин Е.С.Skopets A.A., Kornilov I.A., Afonin E.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.innovmedkub.ru/jour/article/view/210

Представлено клиническое наблюдение за пациенткой с легионеллезной пневмонией, которая развилась на фоне волосатоклеточного лейкоза, потребовавшей использования экстракорпоральной мембранной оксигенации для купирования жизнеугрожающей гипоксии. Активная диагностическая тактика по выявлению этиологического агента (Legionella pneumophila, Acinetobacter baumannii), вызвавшего пневмонию, и выявление формы гемобластоза позволило подобрать оптимальный набор антибактериальных препаратов и препаратов для специфической терапии гемобластоза (мутация BRAFV600E и использование зелборафа). Применение экстракорпоральной мембранной оксигенации (ЭКМО) для лечения критической гипоксемии и предупреждения повреждения легких вследствие механической вентиляции позволило разрешить дыхательную недостаточность и отлучить пациентку от ЭКМО, достигнуть гематологической ремиссии и перевести больную в институт гематологии для проведения дальнейшей терапии.

Clinical observation of the patient with legionella pneumonia which developed in the setting of hairy-cell leukosis, required use of extracorporeal membrane oxygenation for controlling life-threatening hypoxia is presented. Active diagnostic approach for identification of the etiologic agent (Legionella pneumophila, Acinetobacter baumannii) that caused pneumonia, allowed to choose an optimum set of antibacterial agents and medicines for specific therapy of hemoblastosis (BRAFV600E mutation and use of Zelboraf). After correction of respiratory insufficiency and discontinue the patient from ECMO, we could reach hematologic remission and transfer the patient to the Institute of Hematology for further treatment.

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The authors declare that there are no conflicts of interest present.