Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report
Background We successfully treated a case of acute type A aortic dissection in a patient with acute inferior wall infarction as well as severe circulatory and respiratory disorders. Case presentation A 69-year-old woman was diagnosed with acute type A aortic dissection. She received emergency partia...
Ausführliche Beschreibung
Autor*in: |
Suzuki, Kengo [verfasserIn] |
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Format: |
E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2023 |
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Schlagwörter: |
Extracorporeal membrane oxygenation (ECMO) Veno-venous extracorporeal membrane oxygenation (V-V ECMO) Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO) |
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Anmerkung: |
© The Author(s) 2023 |
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Übergeordnetes Werk: |
Enthalten in: Ain-Shams journal of anaesthesiology - [Berlin : Springer Berlin Heidelberg, 2007, 15(2023), 1 vom: 16. Aug. |
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Übergeordnetes Werk: |
volume:15 ; year:2023 ; number:1 ; day:16 ; month:08 |
Links: |
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DOI / URN: |
10.1186/s42077-023-00360-4 |
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Katalog-ID: |
SPR052768686 |
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520 | |a Background We successfully treated a case of acute type A aortic dissection in a patient with acute inferior wall infarction as well as severe circulatory and respiratory disorders. Case presentation A 69-year-old woman was diagnosed with acute type A aortic dissection. She received emergency partial aortic arch replacement and coronary artery bypass grafting. After the cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO) with central cannulation was performed due to severe right heart failure and extensive alveolar hemorrhage. Since the surgery, transesophageal echocardiography was used to monitor her hemodynamic status. The positive end-expiratory pressure (PEEP) was managed based on end-expiratory transpulmonary pressure. Replacement of the ECMO circuit was required every 2–3 days due to intra-circuit thrombus, and continuous renal replacement therapy was started on postoperative day (POD) 8. On POD 13, improvement of cardiac function was observed; we therefore attempted closure of the chest and conversion to veno-venous (V-V) ECMO. However, the patient’s hemodynamics were unstable due to diastolic impairment after the chest closure; thus, peripheral veno-arteriovenous (V-AV) ECMO was introduced. The patient was converted to V-V ECMO on POD 16 and weaned from ECMO on POD 17. The patient was extubated on POD 19. She left the intensive care unit with non-invasive ventilation on POD 20. Conclusions The favorable outcome in the current case can be attributed to the following three points: (1) appropriate ECMO strategies were employed according to the patient’s condition, (2) the patient’s lung condition improved due to transpulmonary pressure monitoring and fluid balance management from an early stage, and (3) we observed respiratory and hemodynamic status during the 50–90-s circulatory arrest periods that occurred during ECMO circuit changes, and this observation contributed to the evaluation of weaning from ECMO. | ||
650 | 4 | |a Extracorporeal membrane oxygenation (ECMO) |7 (dpeaa)DE-He213 | |
650 | 4 | |a Veno-venous extracorporeal membrane oxygenation (V-V ECMO) |7 (dpeaa)DE-He213 | |
650 | 4 | |a Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO) |7 (dpeaa)DE-He213 | |
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700 | 1 | |a Tanaka, Shiori |4 aut | |
700 | 1 | |a Inoue, Satoki |4 aut | |
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10.1186/s42077-023-00360-4 doi (DE-627)SPR052768686 (SPR)s42077-023-00360-4-e DE-627 ger DE-627 rakwb eng Suzuki, Kengo verfasserin aut Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background We successfully treated a case of acute type A aortic dissection in a patient with acute inferior wall infarction as well as severe circulatory and respiratory disorders. Case presentation A 69-year-old woman was diagnosed with acute type A aortic dissection. She received emergency partial aortic arch replacement and coronary artery bypass grafting. After the cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO) with central cannulation was performed due to severe right heart failure and extensive alveolar hemorrhage. Since the surgery, transesophageal echocardiography was used to monitor her hemodynamic status. The positive end-expiratory pressure (PEEP) was managed based on end-expiratory transpulmonary pressure. Replacement of the ECMO circuit was required every 2–3 days due to intra-circuit thrombus, and continuous renal replacement therapy was started on postoperative day (POD) 8. On POD 13, improvement of cardiac function was observed; we therefore attempted closure of the chest and conversion to veno-venous (V-V) ECMO. However, the patient’s hemodynamics were unstable due to diastolic impairment after the chest closure; thus, peripheral veno-arteriovenous (V-AV) ECMO was introduced. The patient was converted to V-V ECMO on POD 16 and weaned from ECMO on POD 17. The patient was extubated on POD 19. She left the intensive care unit with non-invasive ventilation on POD 20. Conclusions The favorable outcome in the current case can be attributed to the following three points: (1) appropriate ECMO strategies were employed according to the patient’s condition, (2) the patient’s lung condition improved due to transpulmonary pressure monitoring and fluid balance management from an early stage, and (3) we observed respiratory and hemodynamic status during the 50–90-s circulatory arrest periods that occurred during ECMO circuit changes, and this observation contributed to the evaluation of weaning from ECMO. Extracorporeal membrane oxygenation (ECMO) (dpeaa)DE-He213 Veno-venous extracorporeal membrane oxygenation (V-V ECMO) (dpeaa)DE-He213 Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO) (dpeaa)DE-He213 Yoshida, Keisuke (orcid)0000-0003-1086-6054 aut Hakozaki, Takahiro aut Tanaka, Shiori aut Inoue, Satoki aut Enthalten in Ain-Shams journal of anaesthesiology [Berlin : Springer Berlin Heidelberg, 2007 15(2023), 1 vom: 16. Aug. (DE-627)768093287 (DE-600)2732723-1 2090-925X nnns volume:15 year:2023 number:1 day:16 month:08 https://dx.doi.org/10.1186/s42077-023-00360-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 1 16 08 |
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10.1186/s42077-023-00360-4 doi (DE-627)SPR052768686 (SPR)s42077-023-00360-4-e DE-627 ger DE-627 rakwb eng Suzuki, Kengo verfasserin aut Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background We successfully treated a case of acute type A aortic dissection in a patient with acute inferior wall infarction as well as severe circulatory and respiratory disorders. Case presentation A 69-year-old woman was diagnosed with acute type A aortic dissection. She received emergency partial aortic arch replacement and coronary artery bypass grafting. After the cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO) with central cannulation was performed due to severe right heart failure and extensive alveolar hemorrhage. Since the surgery, transesophageal echocardiography was used to monitor her hemodynamic status. The positive end-expiratory pressure (PEEP) was managed based on end-expiratory transpulmonary pressure. Replacement of the ECMO circuit was required every 2–3 days due to intra-circuit thrombus, and continuous renal replacement therapy was started on postoperative day (POD) 8. On POD 13, improvement of cardiac function was observed; we therefore attempted closure of the chest and conversion to veno-venous (V-V) ECMO. However, the patient’s hemodynamics were unstable due to diastolic impairment after the chest closure; thus, peripheral veno-arteriovenous (V-AV) ECMO was introduced. The patient was converted to V-V ECMO on POD 16 and weaned from ECMO on POD 17. The patient was extubated on POD 19. She left the intensive care unit with non-invasive ventilation on POD 20. Conclusions The favorable outcome in the current case can be attributed to the following three points: (1) appropriate ECMO strategies were employed according to the patient’s condition, (2) the patient’s lung condition improved due to transpulmonary pressure monitoring and fluid balance management from an early stage, and (3) we observed respiratory and hemodynamic status during the 50–90-s circulatory arrest periods that occurred during ECMO circuit changes, and this observation contributed to the evaluation of weaning from ECMO. Extracorporeal membrane oxygenation (ECMO) (dpeaa)DE-He213 Veno-venous extracorporeal membrane oxygenation (V-V ECMO) (dpeaa)DE-He213 Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO) (dpeaa)DE-He213 Yoshida, Keisuke (orcid)0000-0003-1086-6054 aut Hakozaki, Takahiro aut Tanaka, Shiori aut Inoue, Satoki aut Enthalten in Ain-Shams journal of anaesthesiology [Berlin : Springer Berlin Heidelberg, 2007 15(2023), 1 vom: 16. Aug. (DE-627)768093287 (DE-600)2732723-1 2090-925X nnns volume:15 year:2023 number:1 day:16 month:08 https://dx.doi.org/10.1186/s42077-023-00360-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 1 16 08 |
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10.1186/s42077-023-00360-4 doi (DE-627)SPR052768686 (SPR)s42077-023-00360-4-e DE-627 ger DE-627 rakwb eng Suzuki, Kengo verfasserin aut Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background We successfully treated a case of acute type A aortic dissection in a patient with acute inferior wall infarction as well as severe circulatory and respiratory disorders. Case presentation A 69-year-old woman was diagnosed with acute type A aortic dissection. She received emergency partial aortic arch replacement and coronary artery bypass grafting. After the cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO) with central cannulation was performed due to severe right heart failure and extensive alveolar hemorrhage. Since the surgery, transesophageal echocardiography was used to monitor her hemodynamic status. The positive end-expiratory pressure (PEEP) was managed based on end-expiratory transpulmonary pressure. Replacement of the ECMO circuit was required every 2–3 days due to intra-circuit thrombus, and continuous renal replacement therapy was started on postoperative day (POD) 8. On POD 13, improvement of cardiac function was observed; we therefore attempted closure of the chest and conversion to veno-venous (V-V) ECMO. However, the patient’s hemodynamics were unstable due to diastolic impairment after the chest closure; thus, peripheral veno-arteriovenous (V-AV) ECMO was introduced. The patient was converted to V-V ECMO on POD 16 and weaned from ECMO on POD 17. The patient was extubated on POD 19. She left the intensive care unit with non-invasive ventilation on POD 20. Conclusions The favorable outcome in the current case can be attributed to the following three points: (1) appropriate ECMO strategies were employed according to the patient’s condition, (2) the patient’s lung condition improved due to transpulmonary pressure monitoring and fluid balance management from an early stage, and (3) we observed respiratory and hemodynamic status during the 50–90-s circulatory arrest periods that occurred during ECMO circuit changes, and this observation contributed to the evaluation of weaning from ECMO. Extracorporeal membrane oxygenation (ECMO) (dpeaa)DE-He213 Veno-venous extracorporeal membrane oxygenation (V-V ECMO) (dpeaa)DE-He213 Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO) (dpeaa)DE-He213 Yoshida, Keisuke (orcid)0000-0003-1086-6054 aut Hakozaki, Takahiro aut Tanaka, Shiori aut Inoue, Satoki aut Enthalten in Ain-Shams journal of anaesthesiology [Berlin : Springer Berlin Heidelberg, 2007 15(2023), 1 vom: 16. Aug. (DE-627)768093287 (DE-600)2732723-1 2090-925X nnns volume:15 year:2023 number:1 day:16 month:08 https://dx.doi.org/10.1186/s42077-023-00360-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 1 16 08 |
allfieldsGer |
10.1186/s42077-023-00360-4 doi (DE-627)SPR052768686 (SPR)s42077-023-00360-4-e DE-627 ger DE-627 rakwb eng Suzuki, Kengo verfasserin aut Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background We successfully treated a case of acute type A aortic dissection in a patient with acute inferior wall infarction as well as severe circulatory and respiratory disorders. Case presentation A 69-year-old woman was diagnosed with acute type A aortic dissection. She received emergency partial aortic arch replacement and coronary artery bypass grafting. After the cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO) with central cannulation was performed due to severe right heart failure and extensive alveolar hemorrhage. Since the surgery, transesophageal echocardiography was used to monitor her hemodynamic status. The positive end-expiratory pressure (PEEP) was managed based on end-expiratory transpulmonary pressure. Replacement of the ECMO circuit was required every 2–3 days due to intra-circuit thrombus, and continuous renal replacement therapy was started on postoperative day (POD) 8. On POD 13, improvement of cardiac function was observed; we therefore attempted closure of the chest and conversion to veno-venous (V-V) ECMO. However, the patient’s hemodynamics were unstable due to diastolic impairment after the chest closure; thus, peripheral veno-arteriovenous (V-AV) ECMO was introduced. The patient was converted to V-V ECMO on POD 16 and weaned from ECMO on POD 17. The patient was extubated on POD 19. She left the intensive care unit with non-invasive ventilation on POD 20. Conclusions The favorable outcome in the current case can be attributed to the following three points: (1) appropriate ECMO strategies were employed according to the patient’s condition, (2) the patient’s lung condition improved due to transpulmonary pressure monitoring and fluid balance management from an early stage, and (3) we observed respiratory and hemodynamic status during the 50–90-s circulatory arrest periods that occurred during ECMO circuit changes, and this observation contributed to the evaluation of weaning from ECMO. Extracorporeal membrane oxygenation (ECMO) (dpeaa)DE-He213 Veno-venous extracorporeal membrane oxygenation (V-V ECMO) (dpeaa)DE-He213 Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO) (dpeaa)DE-He213 Yoshida, Keisuke (orcid)0000-0003-1086-6054 aut Hakozaki, Takahiro aut Tanaka, Shiori aut Inoue, Satoki aut Enthalten in Ain-Shams journal of anaesthesiology [Berlin : Springer Berlin Heidelberg, 2007 15(2023), 1 vom: 16. Aug. (DE-627)768093287 (DE-600)2732723-1 2090-925X nnns volume:15 year:2023 number:1 day:16 month:08 https://dx.doi.org/10.1186/s42077-023-00360-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 1 16 08 |
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10.1186/s42077-023-00360-4 doi (DE-627)SPR052768686 (SPR)s42077-023-00360-4-e DE-627 ger DE-627 rakwb eng Suzuki, Kengo verfasserin aut Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background We successfully treated a case of acute type A aortic dissection in a patient with acute inferior wall infarction as well as severe circulatory and respiratory disorders. Case presentation A 69-year-old woman was diagnosed with acute type A aortic dissection. She received emergency partial aortic arch replacement and coronary artery bypass grafting. After the cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO) with central cannulation was performed due to severe right heart failure and extensive alveolar hemorrhage. Since the surgery, transesophageal echocardiography was used to monitor her hemodynamic status. The positive end-expiratory pressure (PEEP) was managed based on end-expiratory transpulmonary pressure. Replacement of the ECMO circuit was required every 2–3 days due to intra-circuit thrombus, and continuous renal replacement therapy was started on postoperative day (POD) 8. On POD 13, improvement of cardiac function was observed; we therefore attempted closure of the chest and conversion to veno-venous (V-V) ECMO. However, the patient’s hemodynamics were unstable due to diastolic impairment after the chest closure; thus, peripheral veno-arteriovenous (V-AV) ECMO was introduced. The patient was converted to V-V ECMO on POD 16 and weaned from ECMO on POD 17. The patient was extubated on POD 19. She left the intensive care unit with non-invasive ventilation on POD 20. Conclusions The favorable outcome in the current case can be attributed to the following three points: (1) appropriate ECMO strategies were employed according to the patient’s condition, (2) the patient’s lung condition improved due to transpulmonary pressure monitoring and fluid balance management from an early stage, and (3) we observed respiratory and hemodynamic status during the 50–90-s circulatory arrest periods that occurred during ECMO circuit changes, and this observation contributed to the evaluation of weaning from ECMO. Extracorporeal membrane oxygenation (ECMO) (dpeaa)DE-He213 Veno-venous extracorporeal membrane oxygenation (V-V ECMO) (dpeaa)DE-He213 Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO) (dpeaa)DE-He213 Yoshida, Keisuke (orcid)0000-0003-1086-6054 aut Hakozaki, Takahiro aut Tanaka, Shiori aut Inoue, Satoki aut Enthalten in Ain-Shams journal of anaesthesiology [Berlin : Springer Berlin Heidelberg, 2007 15(2023), 1 vom: 16. Aug. (DE-627)768093287 (DE-600)2732723-1 2090-925X nnns volume:15 year:2023 number:1 day:16 month:08 https://dx.doi.org/10.1186/s42077-023-00360-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 1 16 08 |
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Suzuki, Kengo |
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Suzuki, Kengo misc Extracorporeal membrane oxygenation (ECMO) misc Veno-venous extracorporeal membrane oxygenation (V-V ECMO) misc Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO) Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report |
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Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report Extracorporeal membrane oxygenation (ECMO) (dpeaa)DE-He213 Veno-venous extracorporeal membrane oxygenation (V-V ECMO) (dpeaa)DE-He213 Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO) (dpeaa)DE-He213 |
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Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report |
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Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report |
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Suzuki, Kengo |
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Suzuki, Kengo Yoshida, Keisuke Hakozaki, Takahiro Tanaka, Shiori Inoue, Satoki |
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successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type a aortic dissection: a case report |
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Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report |
abstract |
Background We successfully treated a case of acute type A aortic dissection in a patient with acute inferior wall infarction as well as severe circulatory and respiratory disorders. Case presentation A 69-year-old woman was diagnosed with acute type A aortic dissection. She received emergency partial aortic arch replacement and coronary artery bypass grafting. After the cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO) with central cannulation was performed due to severe right heart failure and extensive alveolar hemorrhage. Since the surgery, transesophageal echocardiography was used to monitor her hemodynamic status. The positive end-expiratory pressure (PEEP) was managed based on end-expiratory transpulmonary pressure. Replacement of the ECMO circuit was required every 2–3 days due to intra-circuit thrombus, and continuous renal replacement therapy was started on postoperative day (POD) 8. On POD 13, improvement of cardiac function was observed; we therefore attempted closure of the chest and conversion to veno-venous (V-V) ECMO. However, the patient’s hemodynamics were unstable due to diastolic impairment after the chest closure; thus, peripheral veno-arteriovenous (V-AV) ECMO was introduced. The patient was converted to V-V ECMO on POD 16 and weaned from ECMO on POD 17. The patient was extubated on POD 19. She left the intensive care unit with non-invasive ventilation on POD 20. Conclusions The favorable outcome in the current case can be attributed to the following three points: (1) appropriate ECMO strategies were employed according to the patient’s condition, (2) the patient’s lung condition improved due to transpulmonary pressure monitoring and fluid balance management from an early stage, and (3) we observed respiratory and hemodynamic status during the 50–90-s circulatory arrest periods that occurred during ECMO circuit changes, and this observation contributed to the evaluation of weaning from ECMO. © The Author(s) 2023 |
abstractGer |
Background We successfully treated a case of acute type A aortic dissection in a patient with acute inferior wall infarction as well as severe circulatory and respiratory disorders. Case presentation A 69-year-old woman was diagnosed with acute type A aortic dissection. She received emergency partial aortic arch replacement and coronary artery bypass grafting. After the cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO) with central cannulation was performed due to severe right heart failure and extensive alveolar hemorrhage. Since the surgery, transesophageal echocardiography was used to monitor her hemodynamic status. The positive end-expiratory pressure (PEEP) was managed based on end-expiratory transpulmonary pressure. Replacement of the ECMO circuit was required every 2–3 days due to intra-circuit thrombus, and continuous renal replacement therapy was started on postoperative day (POD) 8. On POD 13, improvement of cardiac function was observed; we therefore attempted closure of the chest and conversion to veno-venous (V-V) ECMO. However, the patient’s hemodynamics were unstable due to diastolic impairment after the chest closure; thus, peripheral veno-arteriovenous (V-AV) ECMO was introduced. The patient was converted to V-V ECMO on POD 16 and weaned from ECMO on POD 17. The patient was extubated on POD 19. She left the intensive care unit with non-invasive ventilation on POD 20. Conclusions The favorable outcome in the current case can be attributed to the following three points: (1) appropriate ECMO strategies were employed according to the patient’s condition, (2) the patient’s lung condition improved due to transpulmonary pressure monitoring and fluid balance management from an early stage, and (3) we observed respiratory and hemodynamic status during the 50–90-s circulatory arrest periods that occurred during ECMO circuit changes, and this observation contributed to the evaluation of weaning from ECMO. © The Author(s) 2023 |
abstract_unstemmed |
Background We successfully treated a case of acute type A aortic dissection in a patient with acute inferior wall infarction as well as severe circulatory and respiratory disorders. Case presentation A 69-year-old woman was diagnosed with acute type A aortic dissection. She received emergency partial aortic arch replacement and coronary artery bypass grafting. After the cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO) with central cannulation was performed due to severe right heart failure and extensive alveolar hemorrhage. Since the surgery, transesophageal echocardiography was used to monitor her hemodynamic status. The positive end-expiratory pressure (PEEP) was managed based on end-expiratory transpulmonary pressure. Replacement of the ECMO circuit was required every 2–3 days due to intra-circuit thrombus, and continuous renal replacement therapy was started on postoperative day (POD) 8. On POD 13, improvement of cardiac function was observed; we therefore attempted closure of the chest and conversion to veno-venous (V-V) ECMO. However, the patient’s hemodynamics were unstable due to diastolic impairment after the chest closure; thus, peripheral veno-arteriovenous (V-AV) ECMO was introduced. The patient was converted to V-V ECMO on POD 16 and weaned from ECMO on POD 17. The patient was extubated on POD 19. She left the intensive care unit with non-invasive ventilation on POD 20. Conclusions The favorable outcome in the current case can be attributed to the following three points: (1) appropriate ECMO strategies were employed according to the patient’s condition, (2) the patient’s lung condition improved due to transpulmonary pressure monitoring and fluid balance management from an early stage, and (3) we observed respiratory and hemodynamic status during the 50–90-s circulatory arrest periods that occurred during ECMO circuit changes, and this observation contributed to the evaluation of weaning from ECMO. © The Author(s) 2023 |
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Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report |
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