Abstract
A seven-day assistance by v-v ECMO saved a 52-years-old male patient with postpneumonectomy pulmonary edema. He had undergone right pneumonectomy for his lung cancer. Postpneumonectomy lung edema occurred six hours after operation, and became serious to life-threatening on the second postoperative day. After that, v-v ECMO had been working for seven days with one unit of Carmeda® coating circuit, centrifugal pump and membrane oxygenator (Maxima®). Continuous heparin administration of 400 units/hour had kept ACT level about 200 sec. Under v-v ECMO with blood perfusion of 4.0L/min. and 2L/min. of oxygen flow, it was possible to lighten the condition of the respirator: FiO2; from 1.0 to 0.21 and PEEP; from 8cm H2O to ZEEP. The patient had undergone 5 or 6 times of bronchial toilet everyday and airway pressure and pulmonary arterial pressure had been normalized in the following 7 days. The ECMO was weaned in the 8th postoperative day. During assistance with ECMO, only a little change was observed in platelet counts, d-d dimer, and TAT values; no bleeding nor thromboembolic episodes had been experienced. The goal of ECMO was estimated well by arterio-venous difference of oxygen contents, lung compliance, pulmonary arterial pressure, chest X-ray film and contents of the bronchial drainage. V-v ECMO rescued a patient with lung cancer from life-threatening postpneumonectomy pulmonary edema.
