Reconfiguration from veno-arterial to veno-arterio-venous extracorporeal membrane oxygenation for massive pulmonary embolism.
J Artif Organs
; 25(4): 368-372, 2022 Dec.
Article
in En
| MEDLINE
| ID: mdl-35377031
ABSTRACT
Differential hypoxia may occur after the initiation of femorofemoral veno-arterial extracorporeal membrane oxygenation (VA ECMO) if cardiac function improves while severe respiratory failure is still present, one of the most difficult problems encountered during VA ECMO. Reconfiguration to veno-arterio-venous ECMO (V-AV ECMO) is one of several methods of dealing with differential hypoxia. V-AV ECMO requires triple cannulation and careful management of the reinjection flow, but the risk of bleeding is lower than in a surgical procedure, such as central ECMO or a subclavian artery graft. Herein, we reported a patient with a massive pulmonary embolism who received VA ECMO, which was reconfigured to V-AV ECMO 3 days later when differential hypoxia occurred. A drainage cannula was newly inserted via the right internal jugular vein, and an existing drainage cannula was used for reinjection after repositioning it caudally. V-AV ECMO is an effective and feasible treatment for differential hypoxia despite the paucity of the procedure to date.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pulmonary Embolism
/
Respiratory Insufficiency
/
Extracorporeal Membrane Oxygenation
Limits:
Humans
Language:
En
Journal:
J Artif Organs
Journal subject:
ENGENHARIA BIOMEDICA
Year:
2022
Document type:
Article
Affiliation country:
Japón