Use of extracorporeal membrane oxygenation for pulmonary haemorrhage after pulmonary endarterectomy

Edemsky A.G., Chernyavsky A.M., Kornilov I.A., Shmyrev V.A., Moroz G.B., Deryagin M.N., Novikova N.V., Zaitseva E.A., Galstyan M.G.

National Medical Research Centre named after Academician E.N. Meshalkin under the RF Ministry of Public Health, Novosibirsk, Russia

Pulmonary haemorrhage is one of the most severe complications of pulmonary endarterectomy. To the most effective methods of combating this potentially fatal complication belongs extracorporeal membrane oxygenation (ECMO). In this article we describe a clinical case report regarding intraoperative use of central veno-arterial ECMO for pulmonary haemorrhage following thromboendarterectomy from the pulmonary arteries. According to the data of some authors, long-term ECMO support (for more than 4 days) may lead to such severe consequences as rethrombosis of pulmonary arteries and impairment of cerebral circulation. In our case we managed to avoid such complications, taking into consideration that the duration of ECMO amounted to 21 days. Resulting from the carried out comprehensive therapeutic measures by the time of discharge from hospital, a significant decrease in pulmonary artery pressure was achieved, with events of residual pulmonary hypertension.

KEY WORDS: chronic thromboembolic pulmonary hypertension, pulmonary endarterectomy, pulmonary haemorrhage, extracorporeal membrane oxygenation.

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