Informace o publikaci
OUR EXPERIENCE WITH VV ECMO ASSISTED SURGERY
| Název česky | NAŠE ZKUŠENOSTI S VV ECMO ASISTOVANOU OPERATIVOU |
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| Autoři | |
| Rok publikování | 2025 |
| Druh | Konferenční abstrakty |
| Citace | |
| Popis | Abstract Veno-venous extracorporeal membrane oxygenation (VV ECMO) is a method of extracorporeal support providing adequate oxygenation and elimination of carbon dioxide. By using this method, we are able to provide surgical treatment to highly selected patients who would otherwise be unable to undergo thoracic surgery, including tracheal/carinal surgery and high-risk one-lung ventilation due to previous lung resection or severe lung impairment. This case series presents our experience with elective and acute ECMO-assisted thoracic surgery (excluding lung transplantation and cardiosurgery). Presentation of Cases Between February 2019 and April 2025, 20 VV ECMO-assisted thoracic surgeries were done at St. Anne’s University Hospital in Brno. Patients included 7 women and 13 men with a mean age of 59 years. Patients underwent 10 elective and 10 acute procedures. In elective cases, we performed percutaneous cannulation under ultrasound guidance directly in the operating room and in acute cases we performed cannulation in the intesive care unit. Suction cannulae 23-25F into the femoral vein and return cannulae 19-21F into the jugular vein were used. We administered a bolus of heparin of 2000 j prior to the cannulation, leaving patients completely without anticoagulation peri and postoperatively. We weaned all elective cases from ECMO within 24 hours after surgery, none of the patients had postoperative complications. Acute VV ECMO-assisted surgery was complicated in five patients. Three of these complications (2 cases of hemothorax and the hemoperitoneum) were indicated for acute surgical revision. In acute VV ECMO-assisted surgeries, the median duration of ECMO was 14 (2-16) days. None of the patients died during surgery. The 30-day mortality was 30% (all patients died of complications related to ARDS). The median of hospital length of stay was 21 (18-63) days. In elective VV ECMO –assisted surgery the median duartion of ECMO was 1 day. None of the patients died during surgery. The 30-day mortality was 0%. The median of hospital length of stay was 7 (5-10) days. Conclusion Patients in whom selective intubation and/or ventilation is not feasible but necessary to perform surgery may benefit from VV ECMO. Morbidity and mortality are very low for carefully selected patients undergoing VV ECMO-assisted elective lung resection surgery. Patients with respiratory failure requiring surgical treatment may also benefit from VV ECMO. In this case, morbidity and postoperative mortality are high; however, they are primarily related to the severity of the underlying disease rather than the surgical treatment itself. |