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Total Thyroidectomy while on Extracorporeal Membrane Oxygenation for Thyroid Storm

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Abstract

Thyroid storm is an acute life-threatening condition of hyperthyroidism that can present with cardiac failure, requiring extracorporeal membrane oxygenation (ECMO). We present the first case reported of total thyroidectomy successfully performed while on ECMO for thyroid storm in a 32-year-old male. This case highlights the challenges of managing refractory thyroid storm with multi-organ failure. We demonstrate that total thyroidectomy may still be safely performed while on ECMO for thyroid storm, if steps are taken to optimise the patient perioperatively, with careful surgical and anaesthesia planning.

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References

  1. Chiha M, Samarasinghe S, Kabaker AS (2015) Thyroid Storm: an updated review. J Intensive Care Med 30(3):131–140

    Article  PubMed  Google Scholar 

  2. Scholz GH, Hagemann E, Arkenau C, Engelmann L, Lamesch P, Schreiter D, Schoenfelder M, Olthoff D, Paschke R (2003) Is there a place for thyroidectomy in older patients with thyrotoxic Storm and cardiorespiratory failure? Thyroid 13(10):933–940

    Article  PubMed  Google Scholar 

  3. Hsu LM, Ko WJ, Wang CH (2011) Extracorporeal membrane oxygenation rescues thyrotoxicosis-related circulatory collapse. Thyroid 21(4):439–441

    Article  PubMed  Google Scholar 

  4. Chao A, Wang CH, You HC, Chou NK, Yu HY, Chi NH, Huang SC, Wu IH, Tseng LJ, Lin MH, Chen YS (2015) Highlighting indication of extracorporeal membrane oxygenation in endocrine emergencies. Sci Rep 5(1):13361

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. White A, Bozso SJ, Moon MC (2018) Thyrotoxicosis induced cardiomyopathy requiring support with extracorporeal membrane oxygenation. J Crit Care 45:140–143

    Article  PubMed  Google Scholar 

  6. Genev I, Lundholm MD, Emanuele MA, McGee E, Mathew V (2020) Thyrotoxicosis-induced cardiomyopathy treated with venoarterial extracorporeal membrane oxygenation. Heart Lung 49(2):165–166

    Article  Google Scholar 

  7. Kim S, Seol SH, Kim YS, Kim DK, Kim KH, Kim DI (2018) Thyrotoxicosis induced cardiogenic shock rescued by extracorporeal membrane oxygenation. J Geriatric Cardiol: JGC 15(2):203

    PubMed Central  Google Scholar 

  8. Allencherril J, Birnbaum I (2015) Heart Failure in thyrotoxic cardiomopathy: extracorporeal membrane oxygenation treatment for graves’ disease. J Extracorpor Technol 47(4):231

    Article  Google Scholar 

  9. Wong IM, Lim JY, Goh JT, Tan QL, Tay CK (2021) Thyroid Storm rescued by extracorporeal membrane oxygenation support, plasmapheresis and thyroidectomy: a case report. J Emerg Crit Care Med 5(19):10–21037

    Google Scholar 

  10. Carroll R, Matfin G (2010) Endocrine and metabolic emergencies: thyroid Storm. Therapeutic Adv Endocrinol Metabolism 1(3):139–145

    Article  CAS  Google Scholar 

  11. Ezer A, Caliskan K, Parlakgumus A, Belli S, Kozanoglu I, Yildirim S (2009) Preoperative therapeutic plasma exchange in patients with thyrotoxicosis. J Clin Apheresis: Off J Am Soc Apheresis 24(3):111–114

    Article  Google Scholar 

  12. Zangrillo A, Landoni G, Biondi-Zoccai G, Greco M, Greco T, Frati G, Patroniti N, Antonelli M, Pesenti A, Pappalardo F (2013) A meta-analysis of complications and mortality of extracorporeal membrane oxygenation. Crit Care Resusc 15(3):172–178

    PubMed  Google Scholar 

  13. Taghavi S, Jayarajan SN, Mangi AA, Hollenbach K, Dauer E, Sjoholm LO, Pathak A, Santora TA, Goldberg AJ, Rappold JF (2015) Examining noncardiac surgical procedures in patients on extracorporeal membrane oxygenation. ASAIO J 61(5):520–525

    Article  CAS  PubMed  Google Scholar 

  14. Atkinson JB, Kitagawa H, Humphries B (1992) Major surgical intervention during extracorporeal membrane oxygenation. J Pediatr Surg 27(9):1197–1198

    Article  CAS  PubMed  Google Scholar 

  15. Zhao Y, Li Z, Zhang L, Dong J, Xing C, Yao X, Li C, Wang Y, Guan Y (2022) Extracorporeal membrane oxygenation for thyroid surgery in patients with severe tracheal stenosis. SAGE Open Med Case Rep 10:2050313X221139022

    Article  PubMed  PubMed Central  Google Scholar 

  16. Terefe M, Bizuneh YB, Nigatu YA, Melesse DY (2022) Perioperative management of the thyrotoxic patients: a systematic review. Ann Med Surg 81:104487

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chung YS, Cho DY, Sohn DS, Lee WS, Won H, Lee DH, Kang H, Hong J (2017) Is stopping heparin safe in patients on extracorporeal membrane oxygenation treatment? ASAIO J 63(1):32–36

    Article  PubMed  Google Scholar 

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The authors confirm contribution to the paper as follows: case report paper conception and design; JJW, literature search of relevant data; JJW. Draft manuscript preparation: JJW, KJT, SRBS, SLRH. All authors read and approved the final manuscript.

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Correspondence to Jia Jia Wee.

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Wee, J.J., Tay, K.J., Sudirman, S.R.B. et al. Total Thyroidectomy while on Extracorporeal Membrane Oxygenation for Thyroid Storm. Indian J Otolaryngol Head Neck Surg 76, 2108–2112 (2024). https://doi.org/10.1007/s12070-023-04430-9

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