"Decompression illness" on extracorporeal membrane oxygenation.


Journal

Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113

Informations de publication

Date de publication:
01 Jun 2024
Historique:
received: 29 01 2024
accepted: 25 05 2024
medline: 2 6 2024
pubmed: 2 6 2024
entrez: 2 6 2024
Statut: epublish

Résumé

Extracorporeal membrane oxygenation (ECMO) is increasingly being used for critically ill patients with cardiopulmonary failure. Air in the ECMO circuit is an emergency, a rare but fatal complication. We introduce a case of a 76-year-old female who suffered from cardiac arrest complicated with severe trauma and was administered veno-arterial extracorporeal membrane oxygenation. In managing the patient with ECMO, air entered the ECMO circuit, which had not come out nor was folded or broken. Although the ECMO flow was quickly re-established, the patient died 6 h after initiating ECMO therapy. In this case report, the reason for the complication is drainage insufficiency. This phenomenon is similar to decompression sickness. Understanding this complication is very helpful for educating the ECMO team for preventing this rare but devastating complication of fatal decompression sickness in patients on ECMO.

Sections du résumé

BACKGROUND BACKGROUND
Extracorporeal membrane oxygenation (ECMO) is increasingly being used for critically ill patients with cardiopulmonary failure. Air in the ECMO circuit is an emergency, a rare but fatal complication.
CASE PRESENTATION METHODS
We introduce a case of a 76-year-old female who suffered from cardiac arrest complicated with severe trauma and was administered veno-arterial extracorporeal membrane oxygenation. In managing the patient with ECMO, air entered the ECMO circuit, which had not come out nor was folded or broken. Although the ECMO flow was quickly re-established, the patient died 6 h after initiating ECMO therapy.
CONCLUSIONS CONCLUSIONS
In this case report, the reason for the complication is drainage insufficiency. This phenomenon is similar to decompression sickness. Understanding this complication is very helpful for educating the ECMO team for preventing this rare but devastating complication of fatal decompression sickness in patients on ECMO.

Identifiants

pubmed: 38824529
doi: 10.1186/s13019-024-02815-7
pii: 10.1186/s13019-024-02815-7
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

316

Subventions

Organisme : The Science and Technology Project of Taizhou
ID : 21ywb05
Organisme : The Medicines Health Research Fund of Zhejiang, China
ID : 2022ky435

Informations de copyright

© 2024. The Author(s).

Références

Supady A, Combes A, Barbaro RP, Camporota L, Diaz R, Fan E, et al. Respiratory indications for ECMO: focus on COVID-19. Intensive Care Med. 2022;48(10):1326–37.
doi: 10.1007/s00134-022-06815-w pubmed: 35945343 pmcid: 9362963
Majithia-Beet G, Naemi R, Issitt R. Efficacy of outcome prediction of the respiratory ECMO survival prediction score and the predicting death for severe ARDS on VV-ECMO score for patients with acute respiratory distress syndrome on extracorporeal membrane oxygenation. Perfusion. 2022:2676591221115267.
Teijeiro-Paradis R, Gannon WD, Fan E. Complications Associated with Venovenous extracorporeal membrane oxygenation-what can go wrong? Crit Care Med. 2022.
Zangrillo A, Landoni G, Biondi-Zoccai G, Greco M, Greco T, Frati G, et al. A meta-analysis of complications and mortality of extracorporeal membrane oxygenation. Crit Care Resusc. 2013;15(3):172–8.
pubmed: 23944202
Yan S, Lou S. Air in extracorporeal membrane oxygenation: can never be overemphasized. Perfusion. 2021;36(1):97–9.
doi: 10.1177/0267659120918471 pubmed: 32423312
Chan KM, Wan WTP, Ling L, So JMC, Wong CHL, Tam SBS. Management of Circuit Air in extracorporeal membrane oxygenation: a single Center experience. ASAIO J. 2021.
Sun Q, Gao G. Decompression sickness. N Engl J Med. 2017;377(16):1568.
doi: 10.1056/NEJMicm1615505 pubmed: 29045210
Paul S, Campbell B, Meltzer EC, Sedrakyan A. ECMO as an emergency medical countermeasure. Lancet Respiratory Med. 2014;2(9):685–7.
doi: 10.1016/S2213-2600(14)70166-3
Zakhary B, Vercaemst L, Mason P, Lorusso R, Brodie D. How I manage drainage insufficiency on extracorporeal membrane oxygenation. Crit Care. 2020;24(1):151.
doi: 10.1186/s13054-020-02870-1 pubmed: 32295631 pmcid: 7161276

Auteurs

Jiannan Hu (J)

Department of Critical Care, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, No.150,XiMen Street, Taizhou, 317000, China.
Department of Emergency Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China.

Huijing Zhao (H)

Department of Emergency Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China.

BingBing Bian (B)

Department of Emergency Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China.

Renfei San (R)

Department of Emergency Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China.

Peng Yang (P)

Department of Public Research Platform, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China.

Yongpo Jiang (Y)

Department of Critical Care, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, No.150,XiMen Street, Taizhou, 317000, China. Jyongpo8@163.com.
Department of Emergency Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China. Jyongpo8@163.com.

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