OUR EXPERIENCE WITH VV ECMO ASSISTED SURGERY

a 2025

OUR EXPERIENCE WITH VV ECMO ASSISTED SURGERY

CHOVANEC, Zdeněk; Ivan ČUNDRLE; Adam PEŠTÁL; Alena BERKOVÁ; Vladimír ČERVEŇÁK et al.

Základní údaje

Originální název

OUR EXPERIENCE WITH VV ECMO ASSISTED SURGERY

Název česky

NAŠE ZKUŠENOSTI S VV ECMO ASISTOVANOU OPERATIVOU

Název anglicky

OUR EXPERIENCE WITH VV ECMO ASSISTED SURGERY

Autoři

CHOVANEC, Zdeněk; Ivan ČUNDRLE; Adam PEŠTÁL; Alena BERKOVÁ; Vladimír ČERVEŇÁK a Igor PENKA

Vydání

33rd meeting of the European Society of Thoracic Surgeons, 2025

Další údaje

Typ výsledku

Konferenční abstrakt

Utajení

není předmětem státního či obchodního tajemství

Označené pro přenos do RIV

Klíčová slova česky

akutní, elektivní - VV ECMO, hrudní chirurgie, elektivní, akutní

Klíčová slova anglicky

acute, elective - VV ECMO, thoracic surgery

Změněno: 29. 5. 2025 23:55, MUDr. Zdeněk Chovanec, Ph.D.

Anotace

V originále

Abstract Veno-venous extracorporeal membrane oxygenation (VV ECMO) is a method of extracorporeal support providing adequate oxygenation and elimination of carbon dioxide. By using this method, we are able to provide surgical treatment to highly selected patients who would otherwise be unable to undergo thoracic surgery, including tracheal/carinal surgery and high-risk one-lung ventilation due to previous lung resection or severe lung impairment. This case series presents our experience with elective and acute ECMO-assisted thoracic surgery (excluding lung transplantation and cardiosurgery). Presentation of Cases Between February 2019 and April 2025, 20 VV ECMO-assisted thoracic surgeries were done at St. Anne’s University Hospital in Brno. Patients included 7 women and 13 men with a mean age of 59 years. Patients underwent 10 elective and 10 acute procedures. In elective cases, we performed percutaneous cannulation under ultrasound guidance directly in the operating room and in acute cases we performed cannulation in the intesive care unit. Suction cannulae 23-25F into the femoral vein and return cannulae 19-21F into the jugular vein were used. We administered a bolus of heparin of 2000 j prior to the cannulation, leaving patients completely without anticoagulation peri and postoperatively. We weaned all elective cases from ECMO within 24 hours after surgery, none of the patients had postoperative complications. Acute VV ECMO-assisted surgery was complicated in five patients. Three of these complications (2 cases of hemothorax and the hemoperitoneum) were indicated for acute surgical revision. In acute VV ECMO-assisted surgeries, the median duration of ECMO was 14 (2-16) days. None of the patients died during surgery. The 30-day mortality was 30% (all patients died of complications related to ARDS). The median of hospital length of stay was 21 (18-63) days. In elective VV ECMO –assisted surgery the median duartion of ECMO was 1 day. None of the patients died during surgery. The 30-day mortality was 0%. The median of hospital length of stay was 7 (5-10) days. Conclusion Patients in whom selective intubation and/or ventilation is not feasible but necessary to perform surgery may benefit from VV ECMO. Morbidity and mortality are very low for carefully selected patients undergoing VV ECMO-assisted elective lung resection surgery. Patients with respiratory failure requiring surgical treatment may also benefit from VV ECMO. In this case, morbidity and postoperative mortality are high; however, they are primarily related to the severity of the underlying disease rather than the surgical treatment itself.

Citovat

CHOVANEC, Zdeněk; Ivan ČUNDRLE; Adam PEŠTÁL; Alena BERKOVÁ; Vladimír ČERVEŇÁK a Igor PENKA. OUR EXPERIENCE WITH VV ECMO ASSISTED SURGERY. In 33rd meeting of the European Society of Thoracic Surgeons. 2025.

@proceedings{2499998,
   author = {Chovanec, Zdeněk and Čundrle, Ivan and Peštál, Adam and Berková, Alena and Červeňák, Vladimír and Penka, Igor},
   booktitle = {33rd meeting of the European Society of Thoracic Surgeons},
   keywords = {acute, elective - VV ECMO, thoracic surgery},
   title = {OUR EXPERIENCE WITH VV ECMO ASSISTED SURGERY},
   year = {2025}
}

TY  - CONF
ID  - 2499998
AU  - Chovanec, Zdeněk - Čundrle, Ivan - Peštál, Adam - Berková, Alena - Červeňák, Vladimír - Penka, Igor
PY  - 2025
TI  - OUR EXPERIENCE WITH VV ECMO ASSISTED SURGERY
KW  - acute, elective - VV ECMO, thoracic surgery
N2  - Abstract Veno-venous extracorporeal membrane oxygenation (VV ECMO) is a method of extracorporeal support providing adequate oxygenation and elimination of carbon dioxide. By using this method, we are able to provide surgical treatment to highly selected patients who would otherwise be unable to undergo thoracic surgery, including tracheal/carinal surgery and high-risk one-lung ventilation due to previous lung resection or severe lung impairment. This case series presents our experience with elective and acute ECMO-assisted thoracic surgery (excluding lung transplantation and cardiosurgery). Presentation of Cases Between February 2019 and April 2025, 20 VV ECMO-assisted thoracic surgeries were done at St. Anne’s University Hospital in Brno. Patients included 7 women and 13 men with a mean age of 59 years. Patients underwent 10 elective and 10 acute procedures. In elective cases, we performed percutaneous cannulation under ultrasound guidance directly in the operating room and in acute cases we performed cannulation in the intesive care unit. Suction cannulae 23-25F into the femoral vein and return cannulae 19-21F into the jugular vein were used. We administered a bolus of heparin of 2000 j prior to the cannulation, leaving patients completely without anticoagulation peri and postoperatively. We weaned all elective cases from ECMO within 24 hours after surgery, none of the patients had postoperative complications. Acute VV ECMO-assisted surgery was complicated in five patients. Three of these complications (2 cases of hemothorax and the hemoperitoneum) were indicated for acute surgical revision. In acute VV ECMO-assisted surgeries, the median duration of ECMO was 14 (2-16) days. None of the patients died during surgery. The 30-day mortality was 30% (all patients died of complications related to ARDS). The median of hospital length of stay was 21 (18-63) days. In elective VV ECMO –assisted surgery the median duartion of ECMO was 1 day. None of the patients died during surgery. The 30-day mortality was 0%. The median of hospital length of stay was 7 (5-10) days. Conclusion Patients in whom selective intubation and/or ventilation is not feasible but necessary to perform surgery may benefit from VV ECMO. Morbidity and mortality are very low for carefully selected patients undergoing VV ECMO-assisted elective lung resection surgery. Patients with respiratory failure requiring surgical treatment may also benefit from VV ECMO. In this case, morbidity and postoperative mortality are high; however, they are primarily related to the severity of the underlying disease rather than the surgical treatment itself.
ER  -

CHOVANEC, Zdeněk; Ivan ČUNDRLE; Adam PEŠTÁL; Alena BERKOVÁ; Vladimír ČERVEŇÁK a Igor PENKA. OUR EXPERIENCE WITH VV ECMO ASSISTED SURGERY. In \textit{33rd meeting of the European Society of Thoracic Surgeons}. 2025.

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