Intraoperative support with venovenous extracorporeal membrane oxygenation for complex thoracic oncologic resection

Reis, Flávio Pola dos; Costa, André Nathan; Lauricella, Letícia Leone; Terra, Ricardo Mingarini; Pêgo-Fernandes, Paulo Manuel

doi:10.1590/1806-3713/e20180416

Cited by 3 publications

(4 citation statements)

References 11 publications

(20 reference statements)

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“…Therefore, if it is predicted that hemodynamic instability or respiratory failure may occur during surgery, it is possible to avoid adding ECMO in emergency situations; this would reduce the mortality rate in such situations. Therefore, ECMO may be useful in patients with hemodynamic instability (large mediastinal tumors compressing the heart and great vessels [ 20 ], tumors requiring complex pulmonary resection [ 21 ], or trauma with massive bleeding [ 17 ]) or respiratory failure (large mediastinal mass or pulmonary neoplasm compressing the airways [ 22 ], trachea-bronchial surgery with carinal resection [ 23 ]) during surgery.…”

Section: Discussionmentioning

confidence: 99%

Relationship between 30 Days Mortality and Incidence of Intraoperative Cardiac Arrest According to the Timing of ECMO

Kim

Lee

2021

JCM

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Background: Recently, the use of extracorporeal membrane oxygenation (ECMO) in noncardiac surgery, such as thoracic surgery, has increased. However, there have been no studies on the mortality and incidence of intraoperative cardiac arrest with or without ECMO during thoracic surgery. Methods: Between January 2011 and October 2018, 63 patients received ECMO support during thoracic surgery. All patients who applied ECMO from starting at any time before surgery to the day of surgery were included. Patients were divided into the emergency ECMO group and the non-emergency ECMO group according to the timing of ECMO. We compared the factors related to 30 day mortality using Cox regression analysis. Results: The emergency ECMO and non-emergency ECMO groups comprised 27 and 36 patients, respectively. On the operation day, cardiopulmonary resuscitation (CPR) was a very important result, and only occurred in the emergency ECMO group (n = 20, 74.1% vs. 0%, p < 0.001). The most common cause of ECMO indication was the CPR in the emergency ECMO group and respiratory failure in the non-emergency ECMO group. There were significant differences in 30 day mortality between the emergency ECMO group and the non-emergency ECMO group (n = 12, 44.4% vs. n = 3, 8.3%, p = 0.001). The Kaplan–Meier analysis curve for 30 day mortality showed that the emergency ECMO group had a significantly higher rate of 30 day mortality than the non-emergency ECMO group (X2 = 14.7, p < 0.001). Conclusions: A lower incidence of intraoperative cardiac arrest occurred in the non-emergency ECMO group than in the emergency ECMO group. Moreover, 30 day mortality was associated with emergency ECMO.

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Section: Discussionmentioning

confidence: 99%

Relationship between 30 Days Mortality and Incidence of Intraoperative Cardiac Arrest According to the Timing of ECMO

Kim

Lee

2021

JCM

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“…(9) Uma breve revisão da literatura mostrou que apenas um serviço em nosso país relatou dois casos onde foi usada a ECMO para ressecções oncológicas complexas envolvendo a via aérea. (10) Desta forma, acreditamos ser o primeiro serviço de cirurgia torácica a relatar três casos de pacientes que utilizaram a ECMO para a correção cirúrgica de lesões de via aérea. Em nossa experiência, a ECMO parece ser uma opção satisfatória e segura de suporte ventilatório em pacientes submetidos a cirurgias complexas, permitindo o uso de baixas pressões na via aérea e garantindo uma cicatrização adequada no período pós-operatório.…”

Section: Ao Editorunclassified

Use of extracorporeal membrane oxygenation in the management of severe tracheobronchial injuries

et al. 2021

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“…The main purpose of ECMO is to perform gas exchange (supply oxygen and remove carbon dioxide) and ensure circulatory support, besides allow protective/ultra-protective ventilation. ( 1 - 3 )…”

Section: Introductionmentioning

confidence: 99%

“…The use of ECMO can also provide respiratory and cardiac support in cases of combined cardiopulmonary failure. ( 2 , 3 )…”

Section: Introductionmentioning

confidence: 99%

Flexible broncoscopy in patients in supportive therapy with oxygenation by extracorporeal membrane

Redivo

Lima

Ferreira

et al. 2022

Einstein (São Paulo)

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Objective: To report the experience of performing bronchoscopy in patients who underwent supportive therapy with extracorporeal membrane oxygenation in whom the bronchoscopy was performed. Methods: This was a review of medical records of patients diagnosed with extracorporeal membrane oxygenation and who required diagnostic or therapeutic bronchoscopy. Records included were related to patients admitted to the intensive care unit of Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo , between 2014 and 2020. Results: During the study, 16 bronchoscopies were performed in 8 patients admitted to the intensive care unit and who underwent supportive therapy with extracorporeal membrane oxygenation. The mean age of patients was 28.37 years. Four patients were women (50%). A total of 5 (31.25%) therapeutic bronchoscopies and 11 (68.75%) diagnostics were performed. In 5 of patients, material was collected: 4 samples of bronchoalveolar lavage, three collections of transbronchial biopsies, and 1 of endobronchial biopsies. No patient had radiological worsening or hemodynamic complications. One patient (6.25%) had transient desaturation. There was moderate bleeding after transbronchial biopsy in 1 (6.25%) procedure, which was resolved endoscopically. Conclusion: Patients undergoing extracorporeal membrane oxygenation can safely perform diagnostic or therapeutic bronchoscopy provided that they have a detailed indication. Procedures were performed by a specialized bronchoscopy team in intensive care environment and with the assistance of a qualified multidisciplinary team in membrane oxygenation therapy extracorporeal.

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Intraoperative support with venovenous extracorporeal membrane oxygenation for complex thoracic oncologic resection

Cited by 3 publications

References 11 publications

Relationship between 30 Days Mortality and Incidence of Intraoperative Cardiac Arrest According to the Timing of ECMO

Relationship between 30 Days Mortality and Incidence of Intraoperative Cardiac Arrest According to the Timing of ECMO

Use of extracorporeal membrane oxygenation in the management of severe tracheobronchial injuries

Flexible broncoscopy in patients in supportive therapy with oxygenation by extracorporeal membrane

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