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 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. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Suzuki, Kengo [verfasserIn] Yoshida, Keisuke Hakozaki, Takahiro Tanaka, Shiori Inoue, Satoki

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Extracorporeal membrane oxygenation (ECMO) Veno-venous extracorporeal membrane oxygenation (V-V ECMO) Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO)

Anmerkung:	© The Author(s) 2023

Übergeordnetes Werk:	Enthalten in: Ain-Shams journal of anaesthesiology - [Berlin : Springer Berlin Heidelberg, 2007, 15(2023), 1 vom: 16. Aug.
Übergeordnetes Werk:	volume:15 ; year:2023 ; number:1 ; day:16 ; month:08

Links:	Volltext

DOI / URN:	10.1186/s42077-023-00360-4

Katalog-ID:	SPR052768686

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allfields	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
spelling	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
allfields_unstemmed	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
allfieldsSound	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
language	English
source	Enthalten in Ain-Shams journal of anaesthesiology 15(2023), 1 vom: 16. Aug. volume:15 year:2023 number:1 day:16 month:08
sourceStr	Enthalten in Ain-Shams journal of anaesthesiology 15(2023), 1 vom: 16. Aug. volume:15 year:2023 number:1 day:16 month:08
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Extracorporeal membrane oxygenation (ECMO) Veno-venous extracorporeal membrane oxygenation (V-V ECMO) Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO)
isfreeaccess_bool	true
container_title	Ain-Shams journal of anaesthesiology
authorswithroles_txt_mv	Suzuki, Kengo @@aut@@ Yoshida, Keisuke @@aut@@ Hakozaki, Takahiro @@aut@@ Tanaka, Shiori @@aut@@ Inoue, Satoki @@aut@@
publishDateDaySort_date	2023-08-16T00:00:00Z
hierarchy_top_id	768093287
id	SPR052768686
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR052768686</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20231121064921.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230817s2023 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1186/s42077-023-00360-4</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR052768686</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s42077-023-00360-4-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Suzuki, Kengo</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© The Author(s) 2023</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="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.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Extracorporeal membrane oxygenation (ECMO)</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Veno-venous extracorporeal membrane oxygenation (V-V ECMO)</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO)</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Yoshida, Keisuke</subfield><subfield code="0">(orcid)0000-0003-1086-6054</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Hakozaki, Takahiro</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Tanaka, Shiori</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Inoue, Satoki</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">Ain-Shams journal of anaesthesiology</subfield><subfield code="d">[Berlin : Springer Berlin Heidelberg, 2007</subfield><subfield code="g">15(2023), 1 vom: 16. 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author	Suzuki, Kengo
spellingShingle	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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topic_title	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
topic	misc Extracorporeal membrane oxygenation (ECMO) misc Veno-venous extracorporeal membrane oxygenation (V-V ECMO) misc Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO)
topic_unstemmed	misc Extracorporeal membrane oxygenation (ECMO) misc Veno-venous extracorporeal membrane oxygenation (V-V ECMO) misc Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO)
topic_browse	misc Extracorporeal membrane oxygenation (ECMO) misc Veno-venous extracorporeal membrane oxygenation (V-V ECMO) misc Veno-arteriovenous extracorporeal membrane oxygenation (V-AV ECMO)
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title	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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title_full	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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author_browse	Suzuki, Kengo Yoshida, Keisuke Hakozaki, Takahiro Tanaka, Shiori Inoue, Satoki
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title_sort	successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type a aortic dissection: a case report
title_auth	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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title_short	Successful management by employing situational extracorporeal membrane oxygenation strategies in a patient with acute type A aortic dissection: a case report
url	https://dx.doi.org/10.1186/s42077-023-00360-4
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author2	Yoshida, Keisuke Hakozaki, Takahiro Tanaka, Shiori Inoue, Satoki
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up_date	2024-07-03T14:39:31.758Z
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