Endocrine Emergencies Supported by Extracorporeal Membrane Oxygenation: A Case Series

Problem Statement: This case series showcases the successful use of extracorporeal membrane oxygenation (ECMO) to aid 4 patients facing cardiac collapse or multisystem organ failure due to severe endocrine issues. Background: Between 2019 and 2021, at Maine Medical Center, 4 patients received ECMO for conditions, such as thyroid storm, pheochromocytoma, and post-thyroidectomy complications leading to organ failure. Three patients underwent venoarterial ECMO, and 1 underwent venovenous ECMO. A patient in their 30 s faced multisystem organ failure from thyroid storm and hyperthyroidism, and eventually underwent total thyroidectomy. Another patient in their 30 s experienced severe heart failure and eosinophilic myocarditis and was later discovered to have an extra-adrenal paraganglioma. A patient in their 40 s developed acute respiratory distress syndrome and hypoxia after thyroidectomy for cancer. A patient their 50 s had a cardiac arrest due to a pheochromocytoma. Application: ECMO stabilized these patients, facilitating medical control of endocrine issues and subsequent surgical interventions. Within less than 1 week on ECMO and spending up to 8 days in the hospital pre-ECMO, all patients significantly improved and recovered significantly enough to be discharged home. The findings suggest ECMO could be an effective intervention for endocrine-related cardiogenic shock. Recognizing endocrine disorders as potential causes of cardiac crises is crucial because these conditions can significantly influence heart function to precipitate or exacerbate acute cardiac events. For this reason, it is important to emphasize collaborative efforts between ECMO and endocrine teams for optimal patient care.