Perioperative management of a patient on VA-ECMO undergoing noncardiac surgery. Case report
Keywords:
Extracorporeal Membrane Oxygenation; Tachycardia; Ventricular; Anesthesia; Hemorrhage; Heart Arrest
Abstract
The frequency of extracorporeal membrane oxygenation (ECMO) use in adults has increased in recent years with an increased number of urgent noncardiac surgeries in adults on ECMO. Veno-arterial ECMO (VA-ECMO) is an adaptation of conventional cardiopulmonary bypass technique implemented for prolonged cardiopulmonary support. VA-ECMO is a proven rescue strategy for patients with cardiac arrest who are unresponsive or resistant to conventional cardiopulmonary resuscitation. This mechanical support is a bridging therapy in patients with refractory cardiac arrhythmias who have a poor response to defibrillation and anti-arrhythmic medications. This case report proposes the perioperative anesthetic management of these patients.
References
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2. Douflé G, Roscoe A, Billia F, et al. Echocardiography for adult patients supported with extracorporeal membrane oxygenation. Crit Care 2015;19:326.
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7. Tsai FC, Wang YC, Huang YK, et al. Extracorporeal life support to terminate refractory ventricular tachycardia. Crit Care Med 2007;35:1673-1676.
8. Cohen MI, Gaynor JW, Ramesh V, et al. Extracorporeal membrane oxygenation for patients with refractory ventricular arrhythmias. J Thorac Cardiovasc Surg 1999;118:961-963.
9. Pozzi M, Banfi C, Grinberg D, et al. Veno-arterial extracorporeal membrane oxygenation for cardiogenic shock due to myocarditis in adult patients. J Thorac Dis 2016;8:E495-E502.
10. Chauchan S, Subin S. Extracorporeal membrane oxygenation: an anesthesiologist's perspective - Part 2: clinical and technical consideration. Ann Card Anaesth 2012;15:69-82.
11. Marhong JD, Munshi L, Destky M, et al. Mechanical ventilation during extracorporeal life support (ECLS): a systematic review. Intensive Care Med 2015;41:994-1003.
12. Ranasinghe AM, Peek GJ, Roberts N, et al. The use of trans-esophageal echocardiography to demonstrate obstruction of venous drainage cannula during ECMO. ASAIO J 2004;50:619-620.
13. Kim MK, Park SW, Sim Y, et al. Use of a McGrath Video-laryngoscope to assist transesophageal echocardiography probe insertion in anesthetized patients. J Cardiothorac Vasc Anesth 2015;29:e16-e17.
14. Sangalli F, Patroniti N, Pesenti A. ECMO - Extracorporeal Life Support in Adults. Springer-Verlag Italia, Milan:2014.
15. Foley DS, Pranikoff T, Younger JG, et al. A review of 100 patients transported on extracorporeal life support. ASAIO J 2002;48:612-619.
2. Douflé G, Roscoe A, Billia F, et al. Echocardiography for adult patients supported with extracorporeal membrane oxygenation. Crit Care 2015;19:326.
3. Taghavi S, Jayarajan SN, Mangi AA, et al. Examining noncardiac surgical procedures in patients on extracorporeal membrane oxygenation. ASAIO J 2015;61:520-525.
4. Chauhan S, Subin S. Extracorporeal membrane oxygenation, an anesthesiologist's perspective: physiology and principles. Part 1. Ann Card Anaesth 2011;14:218-229.
5. Chen CY, Tsai J, Hsu TY, et al. ECMO used in a refractory ventricular tachycardia and ventricular fibrillation patient: a national case-control study. Medicine (Baltimore) 2016;95:e3204.
6. Yen CF, Wang CH, Tsai PR, et al. Use of extracorporeal membrane oxygenation to rescue patients with refractory ventricular arrhythmia in acute myocardial infarction. Medicine (Baltimore) 2015;94:e1241.
7. Tsai FC, Wang YC, Huang YK, et al. Extracorporeal life support to terminate refractory ventricular tachycardia. Crit Care Med 2007;35:1673-1676.
8. Cohen MI, Gaynor JW, Ramesh V, et al. Extracorporeal membrane oxygenation for patients with refractory ventricular arrhythmias. J Thorac Cardiovasc Surg 1999;118:961-963.
9. Pozzi M, Banfi C, Grinberg D, et al. Veno-arterial extracorporeal membrane oxygenation for cardiogenic shock due to myocarditis in adult patients. J Thorac Dis 2016;8:E495-E502.
10. Chauchan S, Subin S. Extracorporeal membrane oxygenation: an anesthesiologist's perspective - Part 2: clinical and technical consideration. Ann Card Anaesth 2012;15:69-82.
11. Marhong JD, Munshi L, Destky M, et al. Mechanical ventilation during extracorporeal life support (ECLS): a systematic review. Intensive Care Med 2015;41:994-1003.
12. Ranasinghe AM, Peek GJ, Roberts N, et al. The use of trans-esophageal echocardiography to demonstrate obstruction of venous drainage cannula during ECMO. ASAIO J 2004;50:619-620.
13. Kim MK, Park SW, Sim Y, et al. Use of a McGrath Video-laryngoscope to assist transesophageal echocardiography probe insertion in anesthetized patients. J Cardiothorac Vasc Anesth 2015;29:e16-e17.
14. Sangalli F, Patroniti N, Pesenti A. ECMO - Extracorporeal Life Support in Adults. Springer-Verlag Italia, Milan:2014.
15. Foley DS, Pranikoff T, Younger JG, et al. A review of 100 patients transported on extracorporeal life support. ASAIO J 2002;48:612-619.
How to Cite
1.
Berrio-Valencia MI, McFarlmg MR. Perioperative management of a patient on VA-ECMO undergoing noncardiac surgery. Case report. Colomb. J. Anesthesiol. [Internet]. 2018 Jan. 1 [cited 2024 Apr. 25];46(1):84-7. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/324
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Published
2018-01-01
How to Cite
1.
Berrio-Valencia MI, McFarlmg MR. Perioperative management of a patient on VA-ECMO undergoing noncardiac surgery. Case report. Colomb. J. Anesthesiol. [Internet]. 2018 Jan. 1 [cited 2024 Apr. 25];46(1):84-7. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/324
Issue
Section
Case Report / Case Series
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