Extensive Myocardial Calcification in Critically Ill Patients

Objectives: To describe an unusual complication on extracorporeal membrane oxygenation. Data Sources: Clinical observation. Study Selection: Case report. Data Extraction: Relevant clinical information. Data Synthesis: We report the cases of three young patients who developed extensive myocardial calcifications on prolonged extracorporeal membrane oxygenation support for severe acute respiratory distress syndrome with septic cardiomyopathy, postresuscitation cardiogenic shock, and septic shock complicating severe acute respiratory distress syndrome, respectively. Extensive myocardial calcifications were confirmed by echocardiography, CT, and cardiac biopsy. The combination of multiple factors, for example, prolonged hemodynamic failure, profound acidosis, high vasopressor doses, and renal failure, may lead to this unusual and severe complication. Conclusions: Intensivists should be aware of this rare but rapid complication on extracorporeal membrane oxygenation support that may directly impact outcome. The precise role of extracorporeal membrane oxygenation support in the timing and frequency of new-onset diffuse myocardial calcification deserves further investigation. Dr. Fouret received funding from Office National d’Indemnisation des Accidents médicaux. Dr. Luyt’s institution received funding from Bayer Healthcare, and he received funding from Bayer Healthcare and MSD. The remaining authors have disclosed that they do not have any potential conflicts of interest. Address requests for reprints to: Matthieu Schmidt, MD, PhD, Service de Réanimation Médicale, iCAN, Institute of Cardiometabolism and Nutrition, Hôpital de la Pitié-Salpêtrière, 47, bd de l’Hôpital, Paris, France. E-mail: matthieu.schmidt@aphp.fr Copyright © by 2018 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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