Extracorporeal membrane oxygenation with nafamostat mesilate as an anticoagulant for massive pulmonary hemorrhage after living-donor lobar lung transplantation

Kotani, Kazutoshi; Ichiba, Shingo; Andou, Masanori; Sano, Yoshifumi; Date, Hiroshi; Tedoriya, Takeo; Goto, Keiji; Shimizu, Nobuyoshi

doi:10.1067/mtc.2002.125638

Cited by 19 publications

(25 citation statements)

References 5 publications

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“…However, nafamostatmesilate-an anticoagulant-has been shown to reduce bleeding during ECMO [18] [19]. In the present case, there was a considerable amount of bleeding due to the effect of apixaban, but bleeding was controlled after postoperative day 2.…”

Section: Discussionmentioning

confidence: 64%

Veno-Venous Extracorporeal Membrane Oxygenation for Acute Lung Injury after Surgery for Aortic Dissection: A Case Report

Kono¹,

Oda²,

Akaiwa³

et al. 2017

WJCS

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Acute respiratory failure after surgery for aortic dissection is a serious complication that has been associated with increased mortality and morbidity. Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is reported as one of the treatments for this life-threatening complication. A 78-year-old male patient was admitted to our hospital for Stanford type A acute aortic dissection. He underwent emergency replacement of the ascending aorta, after which he developed acute lung injury. It was difficult to maintain oxygenation with a respirator mask. Therefore, VV-ECMO was initiated on postoperative day 1. The oxygenation gradually improved, and VV-ECMO was continued until postoperative day 13. On postoperative day 25, mechanical ventilation was withdrawn. The patient was discharged from the hospital on postoperative day 149. We report a case of successful treatment of acute lung injury with VV-ECMO initiated after surgery for aortic dissection. VV-ECMO can be considered as a treatment option for severe acute lung injury after surgery for aortic dissection.

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Section: Discussionmentioning

confidence: 64%

Veno-Venous Extracorporeal Membrane Oxygenation for Acute Lung Injury after Surgery for Aortic Dissection: A Case Report

Kono¹,

Oda²,

Akaiwa³

et al. 2017

WJCS

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“…Prophylactic epsilon aminocaproic acid was used in seven of eight trauma patients on ECMO support in one study; however, seven of these patients had significant bleeding [13]. Nafamostat mesilate was used in two patients on ECMO; however, their ACT was regulated between 180 and 200 s [14] and 165 and 190 s [15], respectively, which may have reduced their risk of bleeding. To date, there are no prospective studies for the treatment of MPA alone, and data from Wegener's granulmatosis patients is extrapolated to MPA patients [17].…”

Section: Discussionmentioning

confidence: 95%

“…Regulation of ACT between 160 to 180 s did not exacerbate the pre-existent pulmonary hemorrhage or cause iatrogenic bleeding in our patient. Different techniques including heparin-bonded circuits [12], fibrinolysis inhibitors [13], short acting anticoagulants [14,15] and regulation of ACT between 160 and 180 s [9,10] have been tried with variable success to reduce hemorrhagic complications in patients on ECMO support. Animal studies comparing heparin-coated versus non-heparin-coated systems for ECMO circuit have failed to show any significant difference of coagulation activation markers beyond 6 h of initiation of ECMO [16].…”

Section: Discussionmentioning

confidence: 99%

Extra corporeal membrane oxygenation and plasmapheresis for pulmonary hemorrhage in microscopic polyangiitis

et al. 2005

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“…There are case reports of successful ECMO application to adults with refractory life-threatening respiratory failure due to warfarin-exacerbated diffuse alveolar hemorrhage,30 massive pulmonary hemorrhage after lobar lung transplantation,31 massive lung bleeding with airway blood clot obstruction after pulmonary endarterectomy,32,33 pulmonary hemorrhage related with right middle lobe bronchiectasis,34 and diffuse alveolar hemorrhage after silicone embolism 35…”

Section: Discussionmentioning

confidence: 99%

Successful application of extracorporeal membrane oxygenation due to pulmonary hemorrhage secondary to granulomatosis with polyangiitis

Hohenforst-Schmidt¹,

Petermann²,

Visouli³

et al. 2013

DDDT

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Extracorporeal membrane oxygenation (ECMO) is increasingly applied in adults with acute refractory respiratory failure that is deemed reversible. Bleeding is the most frequent complication during ECMO support. Severe pre-existing bleeding has been considered a contraindication to ECMO application. Nevertheless, there are cases of successful ECMO application in patients with multiple trauma and hemorrhagic shock or head trauma and intracranial hemorrhage. ECMO has proved to be life-saving in several cases of life-threatening respiratory failure associated with pulmonary hemorrhage of various causes, including granulomatosis with polyangiitis (Wegener’s disease). We successfully applied ECMO in a 65-year-old woman with acute life-threatening respiratory failure due to diffuse massive pulmonary hemorrhage secondary to granulomatosis with polyangiitis, manifested as severe pulmonary-renal syndrome. ECMO sustained life and allowed disease control, together with plasmapheresis, cyclophosphamide, corticoids, and renal replacement therapy. The patient was successfully weaned from ECMO, extubated, and discharged home. She remains alive on dialysis at 17 months follow-up.

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Extracorporeal membrane oxygenation with nafamostat mesilate as an anticoagulant for massive pulmonary hemorrhage after living-donor lobar lung transplantation

Cited by 19 publications

References 5 publications

Veno-Venous Extracorporeal Membrane Oxygenation for Acute Lung Injury after Surgery for Aortic Dissection: A Case Report

Veno-Venous Extracorporeal Membrane Oxygenation for Acute Lung Injury after Surgery for Aortic Dissection: A Case Report

Extra corporeal membrane oxygenation and plasmapheresis for pulmonary hemorrhage in microscopic polyangiitis

Successful application of extracorporeal membrane oxygenation due to pulmonary hemorrhage secondary to granulomatosis with polyangiitis

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