Bridging via extracorporeal cardiopulmonary resuscitation for hemodynamic collapse in a patient with metastatic lung cancer: a case report.

IF 1.2 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-12-05 DOI:10.1186/s40981-025-00839-z

Takayuki Hasegawa, Shoe Kobiyama, Ryosuke Sasaki, Tatsusmi Yakushiji, Keisuke Yoshida, Takahiro Hakozaki, Satoki Inoue

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引用次数: 0

Abstract

Background: Due to the highly invasive nature of veno-arterial extracorporeal membrane oxygenation (VA-ECMO), advanced malignancy is considered a relative contraindication. We here report a patient with hemodynamic collapse secondary to metastatic lung cancer in whom bridging via VA-ECMO was successful.

Case presentation: A 35-year-old man with metastatic non-small cell lung cancer harboring a deletion in exon 19 of epidermal growth factor receptor developed acute right ventricular failure and hemodynamic collapse due to pulmonary tumor thrombotic microangiopathy. Because treatment with the targeted agent osimertinib had already been initiated and a rapid response was anticipated, VA-ECMO was instituted as a bridge to its therapeutic effect. The patient's hemodynamics stabilized within 7 days, permitting VA-ECMO decannulation. At the time of writing, the patient is continuing to undergo regular outpatient follow-up.

Conclusions: In carefully selected oncology patients with highly treatment-sensitive disease, short-term VA-ECMO may be an effective bridge to systemic therapy.

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转移性肺癌患者血液动力学衰竭的体外心肺复苏桥接一例报告。

背景：由于静脉-动脉体外膜氧合（VA-ECMO）的高侵入性，晚期恶性肿瘤被认为是相对禁忌症。我们在此报告一例继发于转移性肺癌的血流动力学塌陷患者，经VA-ECMO桥接成功。病例介绍：一名35岁的男性转移性非小细胞肺癌患者，表皮生长因子受体外显子19缺失，由于肺肿瘤血栓性微血管病变导致急性右心室衰竭和血流动力学衰竭。由于靶向药物奥西替尼的治疗已经开始，并且预期会有快速反应，因此VA-ECMO被建立为其治疗效果的桥梁。患者血流动力学在7天内稳定，允许VA-ECMO脱管。在撰写本文时，患者仍在继续接受定期门诊随访。结论：在精心挑选的具有高度治疗敏感性疾病的肿瘤患者中，短期VA-ECMO可能是系统治疗的有效桥梁。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.