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Extracorporeal life support for acute respiratory distress syndrome due to severe Legionella pneumonia.
[legionellosis]
Legionella
is
a
common
cause
of
community-acquired
pneumonia
(
CAP
)
and
is
second
only
to
Pneumococcal
pneumonia
as
a
cause
of
severe
CAP
that
requires
treatment
in
an
intensive
care
unit
.
We
report
a
case
series
of
patients
with
severe
Legionella
pneumonia
who
developed
the
acute
respiratory
distress
syndrome
(
ARDS
)
,
failed
to
improve
with
mechanical
ventilation
alone
and
required
extracorporeal
life
support
(
ECLS
)
.
We
performed
a
retrospective
study
of
all
patients
treated
with
ECLS
at
our
institution
for
severe
ARDS
as
a
result
of
Legionella
pneumonia
from
1994
to
2006
.
A
total
of
twelve
patients
with
a
diagnosis
of
Legionella
pneumonia
were
treated
with
veno-
venous
(
VV
)
ECLS
over
this
time
period
.
Nine
of
these
twelve
(
75
%
)
were
successfully
treated
and
weaned
off
ECLS
and
8
patients
(
67
%
)
survived
to
hospital
discharge
.
Two
(
13
%
)
died
of
multisystem
organ
failure
,
one
patient
(
8
%
)
died
from
global
hypoxic
encephalopathy
and
one
(
8
%
)
was
weaned
from
ECLS
,
but
ultimately
died
of
liver
failure
.
Renal
failure
requiring
some
form
of
continuous
dialysis
occurred
in
seven
patients
(
58
%
)
and
the
survival
for
this
sub-set
of
patients
was
43
%
.
Extracorporeal
life
support
for
severe
ARDS
associated
with
Legionella
pneumonia
is
an
effective
treatment
option
when
mechanical
ventilation
fails
,
especially
when
introduced
early
in
the
course
.
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symptom
legionellosis
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