Venovenous extracorporeal life support after pulmonary endarterectomy: indications, techniques, and outcomes.

Venovenous extracorporeal life support after pulmonary endarterectomy: indications, techniques, and outcomes. Research Abstract Details 

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Venovenous extracorporeal life support after pulmonary endarterectomy: indications, techniques, and outcomes. Abstract Text:

BACKGROUND: Pulmonary endarterectomy is the accepted therapy for thromboembolic pulmonary hypertension. A recognized complication of this surgery is the postoperative development of reperfusion edema, a potentially fatal cause of respiratory failure. Because reperfusion edema can be a reversible process, temporizing support measures may be life saving. METHODS: We retrospectively reviewed our experience with venovenous extracorporeal life support (V-V ECLS) from July 1990 to February 2006, in 20 adult patients (mean age 50.5 +/- 14.5 years) presenting with potentially reversible respiratory failure after pulmonary endarterectomy. This subset of patients comprised 1.12% of our total pulmonary endarterectomy experience during that time (1,790 cases). RESULTS: Overall in-hospital survival was 30.0% for patients requiring ECLS support after pulmonary endarterectomy versus 94.2% for patients who underwent pulmonary endarterectomy alone during the same timeframe. V-V ECLS was instituted at a mean of 86.8 hours after surgery. The mean duration of V-V ECLS was 123.4 +/- 71.3 hours. The most common cause of death in ECLS patients after pulmonary endarterectomy was pulmonary hemorrhage. Survival was greater in patients cannulated within 120 hours of surgery (46.2% survival; 6 of 13 patients) compared with those cannulated after 120 hours (0 of 7 patients). Multiple logistic regression identified long duration of mechanical ventilation pre-ECLS and severity of preoperative pulmonary hypertension together as predictors of mortality. CONCLUSIONS: A small subset of patients undergoing pulmonary endarterectomy develop temporary life-threatening respiratory failure secondary to severe reperfusion edema. In those patients with satisfactory hemodynamic outcome, V-V ECLS is a therapeutic option when all other conventional strategies have been exhausted.

Venovenous extracorporeal life support after pulmonary endarterectomy: indications, techniques, and outcomes. Publishing Authors By Initials

For similar diagnosis: prognosis: treatment outcome research abstracts see: diagnosis: prognosis: treatment outcome research

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Venovenous extracorporeal life support after pulmonary endarterectomy: indications, techniques, and outcomes. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: The Annals of thoracic surgery

VOLUME: 82

Page Numbers: 2139-45

Journal Abbreviation: Ann. Thorac. Surg.

ISSN: 1552-6259

DAY: 3

MONTH: Dec

YEAR: 2006

Venovenous extracorporeal life support after pulmonary endarterectomy: indications, techniques, and outcomes. Information

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LANGUAGE: eng

NlmUniqueID: 15030100

Venovenous extracorporeal life support after pulmonary endarterectomy: indications, techniques, and outcomes. Keywords Mesh Terms:

KEYWORDS: Treatment Outcome

MESH TERMS: therapy

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Grant and Affiliation Information for Venovenous extracorporeal life support after pulmonary endarterectomy: indications, techniques, and outcomes.

AFFILIATION: Division of Cardiothoracic Surgery, University of California, San Diego, San Diego, California 92103-8892, USA. pthistlethwaite@ucsd.edu

Country: Netherlands

AGENCY: United States NHLBI

GRANT: R01 HL70852

ACRONYM: HL

MEDLINETA: Ann Thorac Surg

REFSOURCE: Ann Thorac Surg. 2006 Dec;82(6):2145-6

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