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Thrombotic Complications during Interventional Lung Assist: Case Series.

Kim EJ, Cho WH, Ahn EY, Ryu DG, Lee SE, Jeon DS, Kim YS, Son BS, Kim do H - Tuberc Respir Dis (Seoul) (2015)

Bottom Line: Interventional lung assist (iLA) effectively reduces CO2 retention and allows protective ventilation in cases of life-threatening hypercapnia.Despite the clinical efficacy of iLA, there are a few major limitations associated with the use of this approach, such as bleeding, thrombosis, and catheter-related limb ischemia.We presented two cases in which thrombotic complications developed during iLA.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.

ABSTRACT
Interventional lung assist (iLA) effectively reduces CO2 retention and allows protective ventilation in cases of life-threatening hypercapnia. Despite the clinical efficacy of iLA, there are a few major limitations associated with the use of this approach, such as bleeding, thrombosis, and catheter-related limb ischemia. We presented two cases in which thrombotic complications developed during iLA. We demonstrated the two possible causes of thrombotic complications during iLA; stasis due to low blood flow and inadequate anticoagulation.

No MeSH data available.


Related in: MedlinePlus

Case 1. Clots in the circuit.
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Figure 1: Case 1. Clots in the circuit.

Mentions: A 70-year-old man, who had undergone lung cancer resection 32 months ago, was admitted to the anesthesia department for stump (amputated finger) pain management. During hospitalization, the patient developed pneumonia, and the peripheral capillary oxygen saturation (SpO2) decreased to 89% with mild dyspnea. On day 11 of hospitalization, SpO2 rapidly decreased to 68% while the patient was receiving 100% oxygen via a non-rebreather facemask, and conventional ventilation was initiated. Hypercapnia was intractable despite mechanical ventilation; therefore, he was placed on iLA (Table 1). On the second day of iLA, the iLA flow was zero due to clots in the circuit without anticoagulation (Figure 1); consequently, the iLA membrane was changed and heparin infusion was started. On the tenth day of iLA, clots formed again despite heparin infusion (Table 2). Ultimately, veno-venous ECMO was initiated for effective oxygenation. On the 11th day of ECMO, acute respiratory distress syndrome was not resolved, and the patient died of multi-organ failure.


Thrombotic Complications during Interventional Lung Assist: Case Series.

Kim EJ, Cho WH, Ahn EY, Ryu DG, Lee SE, Jeon DS, Kim YS, Son BS, Kim do H - Tuberc Respir Dis (Seoul) (2015)

Case 1. Clots in the circuit.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4311030&req=5

Figure 1: Case 1. Clots in the circuit.
Mentions: A 70-year-old man, who had undergone lung cancer resection 32 months ago, was admitted to the anesthesia department for stump (amputated finger) pain management. During hospitalization, the patient developed pneumonia, and the peripheral capillary oxygen saturation (SpO2) decreased to 89% with mild dyspnea. On day 11 of hospitalization, SpO2 rapidly decreased to 68% while the patient was receiving 100% oxygen via a non-rebreather facemask, and conventional ventilation was initiated. Hypercapnia was intractable despite mechanical ventilation; therefore, he was placed on iLA (Table 1). On the second day of iLA, the iLA flow was zero due to clots in the circuit without anticoagulation (Figure 1); consequently, the iLA membrane was changed and heparin infusion was started. On the tenth day of iLA, clots formed again despite heparin infusion (Table 2). Ultimately, veno-venous ECMO was initiated for effective oxygenation. On the 11th day of ECMO, acute respiratory distress syndrome was not resolved, and the patient died of multi-organ failure.

Bottom Line: Interventional lung assist (iLA) effectively reduces CO2 retention and allows protective ventilation in cases of life-threatening hypercapnia.Despite the clinical efficacy of iLA, there are a few major limitations associated with the use of this approach, such as bleeding, thrombosis, and catheter-related limb ischemia.We presented two cases in which thrombotic complications developed during iLA.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.

ABSTRACT
Interventional lung assist (iLA) effectively reduces CO2 retention and allows protective ventilation in cases of life-threatening hypercapnia. Despite the clinical efficacy of iLA, there are a few major limitations associated with the use of this approach, such as bleeding, thrombosis, and catheter-related limb ischemia. We presented two cases in which thrombotic complications developed during iLA. We demonstrated the two possible causes of thrombotic complications during iLA; stasis due to low blood flow and inadequate anticoagulation.

No MeSH data available.


Related in: MedlinePlus