• B Bryner, J Miskulin, C Smith, E Cooley, R Grams, R Bartlett, G Annich, and G B Mychaliska.
• 1Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
• Perfusion. 2014 Jan 1;29(1):39-43.

PurposeLegionella 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).MethodsWe 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.ResultsA 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%.ConclusionsExtracorporeal 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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