Pulmonary Complications After Trauma Pneumonectomy

Kazior, Michael R.; Streams, Jill R.; Dennis, Bradley M.; King, Adam; Henson, Christopher P.; Slinger, Peter; McDonald, Sarah; Tong, Jianfeng; Chaney, Mark A.

doi:10.1053/j.jvca.2020.01.057

Cited by 2 publications

(3 citation statements)

References 32 publications

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“…When pneumonectomy is performed emergently for penetrating trauma, the most common mechanisms of death are post-operative pulmonary edema and ARDS ( 3 ). In addition, acute right ventricular failure can lead to hemodynamic instability.…”

Section: Discussionmentioning

confidence: 99%

Trauma pneumonectomy followed by extracorporeal membrane oxygenation cannulation: a case report

Hutchings,

Schwarze,

Was

et al. 2024

AME Case Rep

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Background Trauma pneumonectomy remains an incredibly morbid procedure, reserved for the most critical cases where it is the only surgical option to stop massive ongoing hemorrhage. There are only few cases reported in the literature of survivors of trauma pneumonectomy complicated by acute respiratory distress syndrome (ARDS). We present our case of long-term survival in this circumstance. Given the limited published research on survival after prolonged veno-venous extracorporeal membrane oxygenation (VV-ECMO), it is important to share our experiences using VV-ECMO as an adjunct for pulmonary recovery. Case Description We present a case of a 35-year-old male patient who survived a gunshot wound to the right lung following trauma pneumonectomy with the assistance of VV-ECMO. He developed postoperative hemodynamic instability and required 38 days of VV-ECMO. He ultimately survived discharge from the hospital. One year after his gunshot injury, the patient was living at home with assistance. Urgent VV-ECMO cannulation and a multi-disciplinary approach was lifesaving in the treatment of this patient’s post-pneumonectomy ARDS. Conclusions In review of the literature, ECMO has been used in a few other cases of ARDS following trauma pneumonectomy to allow for full pulmonary recovery. This case highlights the challenges following this morbid procedure, however with a multidisciplinary approach and urgent use of ECMO, a favorable outcome can be achieved.

show abstract

Section: Discussionmentioning

confidence: 99%

Trauma pneumonectomy followed by extracorporeal membrane oxygenation cannulation: a case report

Hutchings,

Schwarze,

Was

et al. 2024

AME Case Rep

View full text Add to dashboard Cite

show abstract

“…The patient exhibits right ventricular failure and pulmonary edema with severe acute hypoxemia. This pulmonary edema is known as post-pneumonectomy pulmonary edema, described very rarely and associated with mortality rates such as 80 to 100% [ 9 ]. VA-ECMO supports lung rest while keeping low mechanical ventilator parameters [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…ECMO support is also associated with numerous complications [ 9 ], such as thrombosis or embolia that require blood products to correct coagulopathy. In this patient, lower limb ischemia was present, however it was related to femoral/arterial cannula ratio.…”

Section: Discussionmentioning

confidence: 99%

Pneumonectomy following penetrating trauma with ECMO as postoperative support: case report – (Lung trauma and ECMO)

Sánchez-Ortiz,

Peña-González,

García

et al. 2024

J Cardiothorac Surg

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Background Penetrating thoracic injuries have a significant risk of morbi-mortality. Despite the advancements in damage control methods, a subset of patients with severe pulmonary vascular lesions and bronchial injuries persists. In some of these cases, post-traumatic pneumonectomy is required, and perioperative extracorporeal membrane oxygenation (ECMO) support may be required due to right ventricular failure and respiratory failure. Case description A male was brought to the emergency department (ED) with a penetrating thoracic injury, presenting with massive right hemothorax and active bleeding that required ligation of the right pulmonary hilum to control the bleeding. Subsequently, he developed right ventricular dysfunction and ARDS, necessitating a dynamic hybrid ECMO configuration to support his condition and facilitate recovery. Conclusions Penetrating thoracic injuries with severe pulmonary vascular lesions may need pneumonectomy to control bleeding. ECMO support reduces the associated mortality by decreasing the complications rate. A multidisciplinary team is essential to achieve good outcomes in severe compromised patients.

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Pulmonary Complications After Trauma Pneumonectomy

Cited by 2 publications

References 32 publications

Trauma pneumonectomy followed by extracorporeal membrane oxygenation cannulation: a case report

Trauma pneumonectomy followed by extracorporeal membrane oxygenation cannulation: a case report

Pneumonectomy following penetrating trauma with ECMO as postoperative support: case report – (Lung trauma and ECMO)

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