Unusual severe hypoxemia due to unilateral pulmonary edema after conventional cardiopulmonary bypass salvaged by veno-venous extracorporeal membrane oxygenation: a case report.

Pub Date : 2023-10-07 DOI:10.1186/s40981-023-00656-2

Masataka Fukuda, Hiroaki Sakai, Keito Koh, Sonoko Sakuraba, Nozomi Ando, Masakazu Hayashida, Izumi Kawagoe

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Abstract

Background: We report a case in which veno-venous extracorporeal membrane oxygenation (V-V ECMO) saved the life of a patient who developed severe hypoxemia due to unusual unilateral pulmonary edema (UPE) after cardiopulmonary bypass (CPB).

Case presentation: A 69-year-old man underwent aortic valve replacement and coronary artery bypass grafting. Following uneventful weaning off CPB, he developed severe hypoxemia. The ratio of arterial oxygen tension to inspired oxygen fraction (PaO₂/FiO₂) decreased from 301 mmHg 5 min after CPB to 42 mmHg 90 min after CPB. A chest X-ray revealed right-sided UPE. Immediately established V-V ECMO increased PaO₂/FiO₂ to 170 mmHg. Re-expansion pulmonary edema (REPE) was likely, as the right lung remained collapsed during CPB following the accidental opening of the right chest cavity during graft harvesting.

Conclusions: V-V ECMO was effective in improving oxygenation and saving the life of a patient who had fallen into unilateral REPE unusually developing after conventional CPB.

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静脉-静脉体外膜肺氧合抢救常规体外循环术后单侧肺水肿引起的异常严重低氧血症：一例报告。

背景：我们报告了一例因体外循环（CPB）后不寻常的单侧肺水肿（UPE）而出现严重低氧血症的患者，其中静脉-静脉体外膜肺氧合（V-V ECMO）挽救了患者的生命。在顺利脱离体外循环后，他出现了严重的低氧血症。动脉氧张力与吸入氧分数之比（PaO2/FiO2）从CPB后5分钟的301 mmHg下降到CPB后90分钟的42 mmHg。胸部X光片显示右侧UPE。立即建立的V-V ECMO将PaO2/FiO2增加到170mmHg。再膨胀性肺水肿（REPE）是可能的，因为在移植物采集过程中，右胸腔意外打开后，在CPB期间右肺仍然塌陷。结论：V-V ECMO可有效改善常规CPB后单侧REPE异常发展患者的氧合，挽救患者的生命。

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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