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Extracorporeal Membrane Oxygenation (ECMO) and Iliac Vein Injury
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Sang Ook Ha, Jae Seok Park, So Hee Park, Chae Man Lim, Younsuck Koh, Sang Bum Hong
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Korean J Crit Care Med. 2013;28(3):197-200.
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DOI: https://doi.org/10.4266/kjccm.2013.28.3.197
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 Abstract
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- The use of extracorporeal membrane oxygenation (ECMO) has increased after the 2009 pandemic H1N1 infections, and the ECMO-related complications have also increased.
Specifically, the mechanical vessel injury due to catheter cannulation seems to be less frequent than other complications, but there is a risk of hemorrhagic shock which requires special attention. We experienced a case of successful management with graft stenting during ECMO operation for iliac vein injury. A 56-year-old female patient with non-small cell lung cancer developed endobronchial obstruction, and ECMO was applied for the ECMO-assisted rigid bronchoscopy. During catheter cannulation, hypovolemic shock was developed due to her right external iliac vein injury. We detected the hemorrhage with bedside ultrasound at an early stage and the hemorrhage was effectively managed with graft stenting on ECMO.
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A Case of Pumpless Interventional Lung Assist Application in a Tuberculosis Destroyed Lung Patient with Severe Hypercapnic Respiratory Failure
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So Hee Park, Sang Ook Ha, Jae Seok Park, Sang Bum Hong, Tae Sun Shim, Chae Man Lim, Younsuck Koh
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Korean J Crit Care Med. 2013;28(3):192-196.
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DOI: https://doi.org/10.4266/kjccm.2013.28.3.192
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Abstract
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- Pumpless extracorporeal interventional lung assist (iLA) is a rescue therapy allowing effective carbon dioxide removals and lung protective ventilator settings. Herein, we report the use of a pumpless extracorporeal iLA in a tuberculosis destroyed lung (TDL) patient with severe hypercapnic respiratory failures. A 35-year-old male patient with TDL was intubated due to CO2 retention and altered mentality.
After 11 days, Ventilator Associated Pneumonia (VAP) had developed. Despite the maximal mechanical ventilator support, his severe respiratory acidosis was not corrected.
We applied the iLA for the management of refractory hypercapnia with respiratory acidosis. This case suggests that the iLA is an effective rescue therapy for TDL patients with ventilator refractory hypercapnia.
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KSCCM
