Intraoperative veno-venous extracorporeal lung support in thoracic surgery: a single-centre experience

Redwan, Bassam; Ziegeler, Stephan; Freermann, S; Nique, Liane; Semik, M; Lavae-Mokhtari, Mahyar; Meemann, Thomas; Dickgreber, N; Fischer, Stefan

doi:10.1093/icvts/ivv253

Cited by 35 publications

(43 citation statements)

References 18 publications

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“…Patients with significant underlying lung disease and poor respiratory reserve generally do not tolerate cessation of ventilation and are managed by the use of selective bronchial blockade or cardiopulmonary bypass. More recently, methods such as veno-venous extracorporeal membrane oxygenation in place of cardiopulmonary bypass during prolonged lung resection have been reported [7][8]. Specific anaesthetic considerations in our case included: 1.…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic approach to VATS in a patient with one lung

Leong

Hwang

2016

Anaesthesia Cases

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Spontaneous pneumothorax after a contralateral pneumonectomy is a potentially fatal condition. It can be treated with pleurodesis via video-assisted thoracoscopic surgery. However, achieving sufficient lung deflation to perform this whilst maintaining good oxygenation in a patient with a single lung is challenging. We describe the anaesthetic management of a 47 year-old male who underwent left-sided video-assisted thoracoscopic pleurodesis for a lifethreatening pneumothorax with a previous right pneumonectomy. We used total intravenous anaesthesia for induction and maintenance of anaesthesia with intermittent apnoeic ventilation. Both adequate surgical field visualisation and oxygenation were achieved. He had an uneventful postoperative course.

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Section: Discussionmentioning

confidence: 99%

Anaesthetic approach to VATS in a patient with one lung

Leong

Hwang

2016

Anaesthesia Cases

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“…Advanced tumors requiring extensive en-bloc resection have been managed with VA ECMO due to the need for vigorous retraction of the heart and great vessels. Both central and peripheral cannulation has been described (24) VV ECMO support is more often reported and is suitable for tracheal and carinal resection including carinal pneumonectomy (26)(27)(28)). An unusual case of repair of a complex tracheoesophageal fistula was reported using pumpless AV ECMO for CO 2 removal.…”

Section: Airway Surgerymentioning

confidence: 99%

“…Post pneumonectomy patients have undergone contralateral wedge resection and segmentectomy for second malignancies (28,32), VATS bullectomy (33) and esophagectomy (34) with VV ECMO support. A low-flow VV ECMO was noted to occasionally be sufficient in patients at risk of severe hypercapnia.…”

Section: Difficult or Impossible One Lung Ventilation (Olv)mentioning

confidence: 99%

“…Thus, VATS resection of bullae has been performed with both VV-ECMO support (28,38) and AV-ECMO (30). In the late 1990's elective intraoperative initiation of ECMO was used to support three COPD patients with severe hypercapnia undergoing lung volume reduction surgery (LVRS), who did not meet standard selection criteria for this procedure (39).…”

Section: Difficult or Impossible One Lung Ventilation (Olv)mentioning

confidence: 99%

“…VV ECMO has been used to facilitate LVRS/major bullectomy to liberate COPD patients from mechanical ventilation (40,41). Additionally VV-ECMO has been used to enable patients with significant loss of lung parenchyma to tolerate resections: metastasectomy after prior extensive lung resection (28) and resection of aspergilloma (42) after scarring from tuberculosis have been reported.…”

Section: Difficult or Impossible One Lung Ventilation (Olv)mentioning

confidence: 99%

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Principles and indications of extracorporeal life support in general thoracic surgery

McRae¹,

Perrot²

2018

J. Thorac. Dis.

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The role of extracorporeal life support (ECLS) has expanded rapidly over the past 15 years to become an important tool in advanced general thoracic surgery practice. Intra-operative and in some cases continued post-operative ECLS is redefining the scope of complex surgical care. ECLS encompasses a spectrum of temporary mechanical support that may remove CO 2 , oxygenate or provide hemodynamic support or a combination thereof. The most common modalities used in general thoracic surgery include extracorporeal membrane oxygenation (ECMO), interventional lung assist device (iLA ® Novalung ® , Heilbronn, Germany), and extracorporeal CO 2 removal (ECCO 2 R). The ECMO and Novalung ® devices can be used in different modes for the short term or long-term support depending on the situation. In this review, the principles and current applications of ECLS in general thoracic surgery are presented.

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Advances in the use of ECMO in oncology patient

Teng

Liao

et al. 2023

Cancer Medicine

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BackgroundOver the past decade, ECMO has provided temporary cardiopulmonary support to an increasing number of patients, but the use of extracorporeal membrane oxygenation (ECMO) to provide temporary respiratory and circulatory support to adult patients with malignancy remains controversial.ObjectivesThis paper reviews the specific use of extracorporeal membrane oxygenation (ECMO) in oncology patients.MethodsWe searched PubMed, CINAHL, Cochrane Library, and Embase databases for studies on the use of ECMO in cancer patients between 1998 and 2022. Twenty‐four retrospective, prospective, and case reports were included. The primary outcome was survival during extracorporeal membrane oxygenation.ResultsMost studies suggest that ECMO can be used in oncology patients requiring life support during surgery, solid tumor patients with respiratory failure, and hematological tumor patients requiring ECOM as a supportive means of chemotherapy; however, in patients with hematologic oncology undergoing hematopoietic stem cell transplantation, there was no clear benefit after the use of ECMO.ConclusionCurrent research suggests that ECMO may be considered as a salvage support in specific cancer patients. Future studies should include larger sample sizes than those already conducted, including studies on efficacy, adverse events, and health.

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Intraoperative veno-venous extracorporeal lung support in thoracic surgery: a single-centre experience

Cited by 35 publications

References 18 publications

Anaesthetic approach to VATS in a patient with one lung

Anaesthetic approach to VATS in a patient with one lung

Principles and indications of extracorporeal life support in general thoracic surgery

Advances in the use of ECMO in oncology patient

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