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Perioperative, protective use of extracorporeal membrane oxygenation in complex thoracic surgery.
- Source :
-
Perfusion . Sep2022, Vol. 37 Issue 6, p590-597. 8p. - Publication Year :
- 2022
-
Abstract
- Background: Extracorporeal membrane oxygenation (ECMO) is increasingly used in patients undergoing complex thoracic surgical procedures. However, studies reporting the clinical outcomes of these patients are limited to case reports, without real consensus. Our aim was to evaluate the perioperative use of ECMO as respiratory and/or circulatory support in thoracic surgery: indications, benefits, and perioperative management. Methods: Between May 2013 and December 2018, we reviewed the clinical data of 15 patients (11 males and 4 females; mean age: 47 years old; range, 25–73 years) undergoing ECMO-assisted thoracic surgery in our hospital. Results: Of the 15 patients, 10 cases received peripheral veno-arterial (VA) ECMO and five cases received veno-venous (VV) ECMO. Indications for ECMO were pulmonary transplantation with hard-to-maintain oxygenation (n = 5), traumatic main bronchial rupture (n = 2), traumatic lung injury (n = 1), airway tumor leading to severe airway stenosis (n = 2), huge thoracic mass infiltrated vena cava (n = 5). The ECMO duration was 1–51 hours. All patients were successfully extubated and weaned from ECMO postoperatively. The main complications were hemorrhage (26.7%), infection (33.3%), acute hepatic dysfunction (33.3%), and venous thrombosis (26.7%). There was only one hospital death and postoperative one-year survival rate was 86%. Conclusion: Our experience indicates that ECMO is a feasible method for complex trachea-bronchial surgery, huge thoracic mass excision and lung transplantation, and the ECMO-related risks may be justified. With further accumulation of experience with ECMO, a more sophisticated protocol for management of critical airway or heart failure problems in thoracic surgeries can be derived. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PERIOPERATIVE care
*LUNG injuries
*ELECTIVE surgery
*PREOPERATIVE care
*THERAPEUTICS
*ECHOCARDIOGRAPHY
*ACADEMIC medical centers
*CHEST X rays
*THORACIC surgery
*LUNG transplantation
*STENOSIS
*VENAE cavae
*LIVER
*POSITIVE end-expiratory pressure
*BLOOD transfusion
*HEMOLYSIS & hemolysins
*EXTRACORPOREAL membrane oxygenation
*SURGICAL complications
*SURGERY
*PATIENTS
*TREATMENT duration
*POSTOPERATIVE care
*RETROSPECTIVE studies
*ACQUISITION of data
*MULTIPLE organ failure
*TREATMENT effectiveness
*INFECTION
*VENOUS thrombosis
*HOSPITAL mortality
*ARTIFICIAL respiration
*BRONCHI
*DESCRIPTIVE statistics
*MEDICAL records
*BLOOD coagulation disorders
*COMPUTED tomography
*HEMORRHAGE
*ACUTE diseases
*SEPTIC shock
*LONGITUDINAL method
*EVALUATION
CHEST tumors
RESPIRATORY organ tumors
Subjects
Details
- Language :
- English
- ISSN :
- 02676591
- Volume :
- 37
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Perfusion
- Publication Type :
- Academic Journal
- Accession number :
- 158883787
- Full Text :
- https://doi.org/10.1177/02676591211011044