Artificial lung support may be necessary in various conditions during the performance of bilateral lung transplantation, and cardiopulmonary bypass (CPB) has usually been used. Yet using the conventional CPB techniques may increase risk of bleeding and early allograft dysfunction due to the large dosages of heparin and the complement activation. Extracorporeal membrane oxygenation (ECMO) is able to support gas exchange and maintain the hemodynamics without administering high-dose heparin for anticoagulation. We performed sequential bilateral lung transplantation with ECMO support. ECMO is a valuable tool when performing lung transplantation and it has the potential to replace CPB.
Cardiopulmonary Bypass ; Complement Activation ; Extracorporeal Circulation ; Extracorporeal Membrane Oxygenation ; Hemodynamics ; Hemorrhage ; Heparin ; Lung ; Lung Transplantation ; Transplantation, Homologous

PURPOSE: Extracorporeal life support (ECLS) is a term used to describe a number of modalities including extracorporeal membrane oxygenation (ECMO) to support cardiac and/or pulmonary systems. The purpose of this study is to review the available evidence regarding the effect of ECLS in patients with acute poisoning. METHODS: Electronic literature searches with PubMed, Embase, Cochrane library, and KoreaMed were conducted for identification of relevant studies addressing ECLS in treatment of acute poisoning. The literature search was conducted by two investigators in March, 2016 with publication language restricted to English and Korean. The toxic substance, technique of ECLS, and final outcome of each case were analyzed. RESULTS: The final analysis included 64 articles including 55 case reports. There were no articles classified according to a high level of evidence such as randomized trial and prospective cohort study. ECLS treatment was used in the management of patients poisoned with 36 unique substances. Venovenous ECMO was performed in 4 cases. Among the reported cases, 10 patients died despite treatment with ECLS. CONCLUSION: Evidence supporting ECLS for patients with acute poisoning is inadequate. However, many case reports suggest that early consideration of ECLS in poisoned patients with refractory cardiac arrest or hemodynamic compromise refractory to standard therapies may be beneficial.
Cardiopulmonary Bypass ; Cohort Studies ; Extracorporeal Circulation ; Extracorporeal Membrane Oxygenation ; Heart Arrest ; Hemodynamics ; Humans ; Poisoning* ; Prospective Studies ; Publications ; Research Personnel

Implanting a pacemaker is the most often used intervention for treating bradycardia. The most commonly used pacemaker is the intracardiac pacemaker, yet it can have many complications. An infected pacemaker can spread to systemic infection and the condition of the patient can quickly get worse, so if an infected pacemaker is suspected, then the pacemaker must be removed. Apart from the use of interventional methods such as a loop or a weight, we can take a more aggressive approach by using extracorporeal circulation for removal of the pacemaker. We report here on two cases in which extracorporeal circulation was used to remove the infected pacemakers.
Bradycardia ; Cardiopulmonary Bypass ; Extracorporeal Circulation ; Humans

BACKGROUND: We evaluated the safety and efficacy of percutaneous extracorporeal membrane oxygenation (ECMO) in patients with primary graft dysfunction after heart transplantation. METHODS: Of 65 patients (44 males and 21 females) who underwent heart transplantation from January 2006 to December 2012, 13 patients (group I) needed peripheral ECMO support due to difficulty in weaning from cardiopulmonary bypass (CPB) and 52 patients (group II) were weaned from CPB without mechanical support. The mean age of the patients at the time of operation was 54.4+/-13.6 years. There were no differences in the preoperative characteristics of the two groups. Multivariable analysis was performed to identify the risk factors for ECMO therapy. RESULTS: All group I patients were successfully weaned from ECMO after 53+/-9 hours of circulatory support. Early mortality occurred in four patients (1 [7.7%] in group I and 3 [5.8%] in group II, p>0.999). There were no differences in the postoperative complications between the two groups, with the exception of reoperation for bleeding. A greater number of group I patients underwent reoperation for bleeding (5 [38.5%] in group I vs. 6 [11.5%] in group II, p=0.035). In multivariable analysis, preoperative mechanical support (ECMO and intra-aortic balloon pump) and longer CPB time were the risk factors of ECMO therapy for graft dysfunction (odds ratio, 6.377; 95% confidence interval, 1.519 to 26.77; p=0.011 and odds ratio, 1.010; 95% confidence interval, 1.001 to 1.019; p=0.033). CONCLUSION: Percutaneous ECMO support could be a viable option for rescuing patients when graft dysfunction refractory to medical management develops after heart transplantation.
Cardiopulmonary Bypass ; Extracorporeal Circulation ; Extracorporeal Membrane Oxygenation* ; Heart Transplantation* ; Heart* ; Hemorrhage ; Humans ; Male ; Mortality ; Odds Ratio ; Postoperative Complications ; Primary Graft Dysfunction ; Reoperation ; Risk Factors ; Transplants* ; Weaning

Amniotic fluid embolism is rare but is one of the most catastrophic complications in the peripartum period. This syndrome is caused by a maternal anaphylactic reaction to the introduction of fetal material into the pulmonary circulation. When amniotic fluid embolism is suspected, the immediate application of extracorporeal mechanical circulatory support such as veno-arterial extracorporeal membrane oxygenation (ECMO) or cardiopulmonary bypass should be considered. Without the application of extracorporeal mechanical circulatory support, medical supportive care might not be sufficient to maintain cardiopulmonary stabilization in severe cases of amniotic fluid embolism. In this report, we present the case of a 36-year-old pregnant woman who developed an amniotic fluid embolism immediately after a cesarean section. Her catastrophic event started with the sudden onset of severe hypoxia, followed by circulatory collapse within 8 minutes. The veno-arterial mode of extracorporeal membrane oxygenation was initiated immediately. She was successfully resuscitated but with impaired cognitive function. Thus, urgent ECMO should be considered when amniotic fluid embolism syndrome is suspected in patients presenting acute cardiopulmonary collapse.
Adult ; Amniotic Fluid* ; Anaphylaxis ; Anoxia ; Cardiopulmonary Bypass ; Cesarean Section ; Cognition ; Embolism, Amniotic Fluid* ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Peripartum Period ; Pregnancy ; Pregnant Women ; Pulmonary Circulation ; Shock

Amniotic fluid embolism is rare but is one of the most catastrophic complications in the peripartum period. This syndrome is caused by a maternal anaphylactic reaction to the introduction of fetal material into the pulmonary circulation. When amniotic fluid embolism is suspected, the immediate application of extracorporeal mechanical circulatory support such as veno-arterial extracorporeal membrane oxygenation (ECMO) or cardiopulmonary bypass should be considered. Without the application of extracorporeal mechanical circulatory support, medical supportive care might not be sufficient to maintain cardiopulmonary stabilization in severe cases of amniotic fluid embolism. In this report, we present the case of a 36-year-old pregnant woman who developed an amniotic fluid embolism immediately after a cesarean section. Her catastrophic event started with the sudden onset of severe hypoxia, followed by circulatory collapse within 8 minutes. The veno-arterial mode of extracorporeal membrane oxygenation was initiated immediately. She was successfully resuscitated but with impaired cognitive function. Thus, urgent ECMO should be considered when amniotic fluid embolism syndrome is suspected in patients presenting acute cardiopulmonary collapse.
Adult ; Amniotic Fluid ; Anaphylaxis ; Anoxia ; Cardiopulmonary Bypass ; Cesarean Section ; Cognition ; Embolism, Amniotic Fluid ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Peripartum Period ; Pregnancy ; Pregnant Women ; Pulmonary Circulation ; Shock

We report on the application of a venovenous type extracorporeal membrane oxygenator (ECMO) in high-risk tracheal procedures in six cases consisting of five patients with tracheal stenosis. An ECMO should be helpful for preventing respiratory emergency during a tracheal procedure.
Emergencies ; Extracorporeal Circulation ; Extracorporeal Membrane Oxygenation ; Humans ; Membranes ; Oxygenators, Membrane ; Tracheal Stenosis

Status asthmaticus is a rare, fatal condition, especially in children. Sometimes respiratory support is insufficient with a mechanical ventilator or medical therapy for patients with status asthmaticus. In such situations, early extracorporeal membrane oxygenation application is a useful method for treating refractory respiratory failure. We report on a case of a six-year-old, male child who underwent venovenous extracorporeal membrane oxygenation support for refractory status asthmaticus.
Asthma ; Child ; Extracorporeal Circulation ; Extracorporeal Membrane Oxygenation ; Humans ; Male ; Respiratory Insufficiency ; Status Asthmaticus ; Ventilators, Mechanical

The use of extracorporeal membrane oxygenation in cardiopulmonary resuscitation has remarkably increased in recent times. We report here on a case of successful resuscitation with using ECMO for a patient who suffered from repeated life threatening hemoptysis. We applied both veno-venous and veno-arterial ECMO to treat this patient's respiratory failure and cardiac arrest, respectively. By clinically judging the different cardiopulmonary conditions of this patient, we were able to apply the appropriate types of ECMO.
Cardiopulmonary Resuscitation ; Extracorporeal Circulation ; Extracorporeal Membrane Oxygenation ; Heart Arrest ; Hemoptysis ; Humans ; Respiratory Insufficiency ; Resuscitation

Blunt bronchial injuries rarely occur in children. This can be a life threatening condition and respiratory management is important for successful treatment. We present here a pediatric patient who had traumatic bronchial transection with difficult airway management. Surgical treatment was carried out under ventilatory support using extracorporeal membrane oxygenation (ECMO) in the emergency room. During the application of ECMO, systemic heparization was unnecessary and there were no thrombotic complications. In conclusion, ventilatory support using ECMO is useful for treating selected patients with blunt trauma regardless of using heparin.
Airway Management ; Bronchi ; Child ; Emergencies ; Extracorporeal Circulation ; Extracorporeal Membrane Oxygenation ; Heparin ; Humans