ECMO for Acute Respiratory Distress Syndrome After Thoracoabdominal Aortic Aneurysm Repair

Chatterjee, Subhasis; Mulvoy, William; Preventza, Ourania; Cruz, Kim I. de la; LeMaire, Scott A.; Coselli, Joseph S.

doi:10.1016/j.athoracsur.2018.04.045

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…With recent advances, VA-ECMO has become more widely used in the field of cardiothoracic surgery as a bridge to transplant or recovery [4] , [5] . Additionally, many cases have detailed its success in maintaining hemodynamic stability following surgical treatment of iatrogenic type A aortic dissections and acute respiratory distress syndrome, following thoracoabdominal aortic aneurysm (TAAA) repair [8] , [9] . The majority of these studies have emphasized the use of ECMO for post-operative circulatory support following vascular interventions, while peri-operative utilization of ECMO in the vascular surgery field remains largely unexplored in literature ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Utilization of ECMO in vascular surgery: A presentation of two cases

Shoukry

Jorgensen

Solak

et al. 2021

International Journal of Surgery Case Reports

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Introduction Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a form of temporary mechanical circulatory support commonly used during cardiothoracic interventions. Malperfusion during complex vascular procedures remains a significant risk that may potentially lead to multiple complications. Here, we report two cases highlighting the efficacy of VA-ECMO in both planned and emergent vascular interventions. Presentation of case In our first case, VA-ECMO was used to support an 82-year-old male during a high-risk thoracoabdominal aortic aneurysm repair. Our second case details an emergent pulmonary embolectomy in which VA-ECMO was used as a bridge to cardiopulmonary bypass. In both cases, the procedures were well-tolerated, and the patients were discharged 17 days postoperatively. Discussion VA-ECMO has been increasingly used as a form of post-operative circulatory support following cardiothoracic and vascular interventions. However, only few instances of perioperative VA-ECMO use have been reported in the field of vascular surgery. Conclusion The presented cases highlight that the perioperative use of VA-ECMO may be a viable modality for required perfusion during complex planned or emergent vascular procedures.

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Section: Discussionmentioning

confidence: 99%

Utilization of ECMO in vascular surgery: A presentation of two cases

Shoukry

Jorgensen

Solak

et al. 2021

International Journal of Surgery Case Reports

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“…Tracheostomy timing and technique (open versus percutaneous dilational) should follow local practice. Early tracheostomy (< 14 days after surgery) is recommended to facilitate mobility, reduce the risk for pneumonia, and promote ventilator weaning [44] . Venovenous extracorporeal membrane oxygenation has been used successfully in cases of severe hypoxemia [45] .…”

Section: Pulmonarymentioning

confidence: 99%

Optimal perioperative care for thoracoabdominal and descending thoracic aortic aneurysm repair: a review

2023

Vessel Plus

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In this review, the authors discuss the perioperative management of patients who undergo thoracoabdominal aortic aneurysm or descending thoracic aortic aneurysm repair. All major organ systems are potentially vulnerable to complications from these repairs; meticulous preoperative attention to optimizing relevant comorbidities, diligent performance of intraoperative anesthetic and surgical techniques, and careful postoperative management are necessary to maximize the likelihood of successful outcomes. Specific attention should be given to reducing the risk for spinal cord ischemia and for paraplegia. Of note, renal and respiratory systems are especially vulnerable to major complications and require a thoughtful multidisciplinary approach. Because preventing complications is the primary goal of perioperative management, deviations from the normal course must be recognized promptly and addressed aggressively to reduce the likelihood of major morbidity and death.

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“…27 In extreme cases of postoperative respiratory failure, we have resorted to independent lung ventilation or extracorporeal membrane oxygenation. 28 Chest tubes are removed when serous drainage is less than 150 mL/d and without evidence of blood, chyle, or air leak.…”

Section: Respiratorymentioning

confidence: 99%