Efficacy of "Awake ECMO" for critical respiratory failure after pediatric open-heart surgery.
J Artif Organs
; 19(2): 196-9, 2016 Jun.
Article
en En
| MEDLINE
| ID: mdl-26670317
ABSTRACT
A 4-year-old boy with atrioventricular discordance, double-outlet right ventricle, pulmonary stenosis, and mitral regurgitation, was undergoing anatomical repair consisting of Senning, Rastelli, Damus-Kaye-Stansel procedures, and a mitral valve repair, complained of post-operative excessive airway tract secretion, which ultimately developed into acute respiratory distress syndrome (ARDS) 28 days after the operation. The cause of the ARDS was thought to be frequent manual positive pressure recruitment and prolonged inhalation of pure oxygen. At 45 days after the operation, hypercapnia and respiratory acidosis turned out to be irreversible, and therefore, veno-arterial extracorporeal membrane oxygenation (ECMO) was established utilizing the Endumo(®)4000 system. Pulmonic interstitial inflammation gradually improved while resting the lung under ECMO support; however, effective ventilation volume decreased critically because a massive pulmonary hemorrhage occurred at 2 and 9 days after the initiation of ECMO. To maximize the effectiveness of respiratory physical therapy, "Awake ECMO" was started and tidal volume dramatically increased with a regained cough reflex. Five days later, he was successfully weaned off from ECMO, and discharged 7 months after the operation without any neurological and physiological sequelae.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Síndrome de Dificultad Respiratoria
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Oxigenación por Membrana Extracorpórea
/
Procedimientos Quirúrgicos Cardíacos
Tipo de estudio:
Guideline
Límite:
Child, preschool
/
Humans
/
Male
Idioma:
En
Revista:
J Artif Organs
Asunto de la revista:
ENGENHARIA BIOMEDICA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Japón