Venovenous Extracorporeal Membrane Oxygenation for Postoperative Acute Respiratory Distress Syndrome

Seo, Dong Ju; Yoo, Jae Suk; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won

doi:10.5090/kjtcs.2015.48.3.180

Cited by 20 publications

(41 citation statements)

References 16 publications

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“…reported an in‐hospital survival rate after ECMO for postoperative ARDS of 18.8%. Prolonged pre‐ECMO ventilator support was a risk factor associated with in‐hospital mortality . In our study, seven patients received ECMO‐based management.…”

Section: Discussionmentioning

confidence: 99%

Intensive care unit (ICU) readmission after major lung resection: Prevalence, patterns, and mortality

et al. 2016

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BackgroundThe aim of this study was to identify risk factors associated with mortality in patients re‐admitted to an intensive care unit (ICU) after initial recovery from major lung resection.MethodsWe retrospectively reviewed the case records of all patients who underwent major lung resection between February 2011 and May 2013. A total of 1916 patients underwent major resection surgery for various lung diseases, 63 (3.3%) of which required ICU admission after initial recovery. We analyzed preoperative and perioperative data, including ICU factors and outcomes.ResultsThe patient group included 57 men (90.5%) with a mean age of 65.3 years. Pathologic diagnosis was malignancy in 92.1% of patients, while 7.9% had benign disease. Open thoracotomy was performed in 84.1%, whereas minimally invasive approaches were performed in 15.9%. In‐hospital mortality occurred in 16 (25.4%) patients. Patients were classified as either survivors (n = 47, 74.6%) or non‐survivors (n = 16, 25.4%). The most common reason for ICU readmission was pulmonary complication (n = 50, 79.4%). Thirty‐one patients (49.2%) required mechanical ventilation, seven (11.1%) required extracorporeal membrane oxygenation, and three (4.8%) required renal support. Multivariate analysis showed that acute respiratory distress syndrome (ARDS) and delirium were independent risk factors for in‐hospital mortality. In addition, delirium frequently occurred in patients with ARDS.Conclusion ARDS and delirium were independent risk factors for in‐hospital mortality in patients who were readmitted to the ICU after major lung resection. Future studies are needed to determine if the prevention of delirium and ARDS can improve postoperative outcomes for patients with lung cancer.

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Section: Discussionmentioning

confidence: 99%

Intensive care unit (ICU) readmission after major lung resection: Prevalence, patterns, and mortality

et al. 2016

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“…ECLS is an advanced technology for refractory cardiopulmonary failure. Previous reports demonstrated the effectiveness of VA ECLS for cardiogenic shock or refractory heart failure as a bridge to recovery or bridge to a ventricular assist device or heart transplantation, and VV ECLS for severe respiratory failure as a bridge to recovery or bridge to lung transplantation compared with conventional therapy, suggesting that ECLS can be also applied after general thoracic surgery with lifethreatening cardiopulmonary complications [12][13][14][15]. However, these were case reports or included other operation types.…”

Section: Commentmentioning

confidence: 99%

“…Cardiovascular complications can occur in as many as 30% of patients after general thoracic surgery and can also lead to increased morbidity and mortality [11]. ECLS can be a useful therapeutic option in these lifethreatening circumstance [7,[12][13][14][15]. However, most of these reports were case reports.…”

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confidence: 99%

“…However, most of these reports were case reports. Although Seo and associates [15] reported the results of postoperative ECLS (weaning success 49.3%, survival 18.8%) for 69 patients, the study was not focused on the thoracic surgery. Tang and colleagues [7] described only 3 ECLS cases (2 survivors) of fulminant ARDS among 22 ARDS patients after pulmonary resection.…”

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confidence: 99%

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The Outcome of Extracorporeal Life Support After General Thoracic Surgery: Timing of Application

Lee

Cho

Chang

et al. 2017

The Annals of Thoracic Surgery

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“…Prior to the utilization of adult ECMO, these conditions carried a high mortality rate . The use of veno‐venous (VV) ECMO has been described in the postoperative period in managing patients with severe pulmonary complications refractory to conventional therapy following different general surgery procedures . ECMO provides temporary cardiorespiratory support to the patient while awaiting the heart and lungs to recover from the primary insult.…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal membrane oxygenation support following liver transplantation—A case series

Goussous

Akbar

LaMattina

et al. 2019

Clinical Transplantation

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| INTRODUC TI ONOnce a therapy for neonates with severe respiratory and cardiac impairment, extracorporeal membrane oxygenation (ECMO) is being utilized with greater frequency in the critically ill adult population. 1-4 ECMO has shown encouraging results as a rescue therapy that serves as a replacement for pulmonary and/or cardiovascular function while the heart and lungs recover from a catastrophic insult in the postoperative period. At our center, ECMO has been utilized with increasing frequency in the critically ill adult population. 5 Prior to transplantation, patients with liver failure often have multiple organ system impairment. Coagulopathy, portal hypertension, and an impaired immune system are chief among the maladies associated with acute and chronic liver disease. 6-8 In the perioperative period, the added stress of a rigorous surgery and subsequent liver engraftment may lead to further physiological derangements that predispose patients to cardiopulmonary failure. 9,10 These can lead to intrinsic lung conditions, such as ARDS or to cardiopulmonary failure from right heart impairment and pulmonary thrombosis. Prior to the utilization of adult ECMO, these conditions carried a high mortality rate. 11 The use of veno-venous (VV) ECMO has been Abstract Background: Postoperative severe cardiopulmonary failure carries a high rate of mortality. Extracorporeal membrane oxygenation (ECMO) can be used as a salvage therapy when conventional therapies fail. Methods: We retrospectively reviewed our experience with ECMO support in the early postoperative period after liver transplant between September 2011 and May 2016.Results: Out of 537 liver transplants performed at our institution, seven patients required ECMO support with a median age of 52 and a median MELD score of 28.Veno-venous ECMO was used in four patients with severe respiratory failure while the rest required veno-arterial ECMO for circulatory failure. The median time from transplant to cannulation was 3 days with a median duration of ECMO support of 7 days. All patients except one were successfully decannulated. The median hospital length of stay was 58 days with an in-hospital mortality of 28.6%. Conclusion:Extracorporeal membrane oxygenation can be considered a viable rescue therapy in the setting of severe postoperative cardiopulmonary failure.Extracorporeal membrane oxygenation therapy was successful in saving patients who were otherwise unsalvageable. K E Y W O R D Scardiopulmonary failure, ECMO, liver failure

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Venovenous Extracorporeal Membrane Oxygenation for Postoperative Acute Respiratory Distress Syndrome

Cited by 20 publications

References 16 publications

Intensive care unit (ICU) readmission after major lung resection: Prevalence, patterns, and mortality

Intensive care unit (ICU) readmission after major lung resection: Prevalence, patterns, and mortality

The Outcome of Extracorporeal Life Support After General Thoracic Surgery: Timing of Application

Extracorporeal membrane oxygenation support following liver transplantation—A case series

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