A case report of prolonged (71 days) and continuous use of venovenous extracorporeal membrane oxygenation (VV-ECMO) without changing the line and VV-ECMO equipment in progressive respiratory failure after blunt chest injury

Authors

  • Niramol Balchon Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Thailand
  • Noppon Taksaudom Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand
  • Kaweesak Chittawatanarat Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand
  • Jarin Phirompaksar Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Thailand
  • Chartaroon Rimsukcharoenchai Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand
  • Kamtone Chandacham Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand
  • Apichat Tantraworasin Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand
  • Tidarat Jirapongcharoenlap Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand
  • Narain Chotirosniramit Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand

Keywords:

extracorporeal membrane oxygenation, severe chest injury, severe respiratory failure, complication, เครื่องแลกเปลี่ยนออกซิเจนนอกร่างกาย, การบาดเจ็บของปอดอย่างรุนแรง, ระบบการหายใจล้ม, เหลวอย่างรุนแรง, ภาวะแทรกซ้อน

Abstract

The use of extracorporeal membrane oxygenation (ECMO) in a trauma setting is a treatment preserved as a rescue therapy for unsuccessful conventional treatment modalities. A 21 year-old male patient was transferred from a secondary hospital after 2 weeks of multiple trauma, due to progressive respiratory failure, with bilateral air leakage of the lung. He received cardiopulmonary resuscitation and high setting of cardiopulmonary support. The venovenous ECMO (VV-ECMO) was initiated after fully conventional therapy failed. The clinical parameters of vital signs, gas exchange, hemodynamics and consciousness were improved after VV-ECMO was initiated. However, he could not tolerate weaning on ECMO. In addition, a massively clotted hemothorax was detected in the left lung 64 days after ECMO. The patient underwent a thoracotomy three times for blood clot removal and to stop the bleeding. Unfortunately, the patient could not tolerate the last operation and he passed away. The total time of VV-ECMO was 71 days without changing the line and equipment, and complications arose. In conclusion, this is a fi rst case in this institute of ECMO initiation in a trauma setting, with the longest duration of VV-ECMO without changing the line and equipment. However, the complications of bleeding and underlying lung pathology resulted in an adverse outcome.

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Published

2023-08-31

How to Cite

1.
Balchon N, Taksaudom N, Chittawatanarat K, Phirompaksar J, Rimsukcharoenchai C, Chandacham K, Tantraworasin A, Jirapongcharoenlap T, Chotirosniramit N. A case report of prolonged (71 days) and continuous use of venovenous extracorporeal membrane oxygenation (VV-ECMO) without changing the line and VV-ECMO equipment in progressive respiratory failure after blunt chest injury. BSCM [Internet]. 2023 Aug. 31 [cited 2024 Dec. 23];55(2):65-73. Available from: https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/87740

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Original Article