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Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Thoracotomy in adults while on ECMO is associated with uncontrollable bleeding
Silvana F Marasco1, Arthur Preovolos, Kiat Lim
1CJOB Cardiothoracic Surgical Unit, The Alfred Hospital, Melbourne, Australia. s.marasco@alfred.org.au
Perfusion
|July 18, 2007
Summary
Extracorporeal membrane oxygenation (ECMO) patients undergoing thoracotomy experienced uncontrollable bleeding, leading to death in most cases. This highlights the need for improved anticoagulation management protocols during ECMO support for safer surgical interventions.
Area of Science:
- Cardiovascular Surgery
- Critical Care Medicine
- Hematology
Background:
- Extracorporeal membrane oxygenation (ECMO) provides vital cardiorespiratory support.
- Thoracotomy is a complex surgical procedure sometimes necessary in ECMO patients.
- Anticoagulation management is critical for ECMO patients to prevent thrombosis and hemorrhage.
Observation:
- Four ECMO patients required emergent thoracotomy.
- Massive, uncontrollable bleeding occurred in three of the four patients post-thoracotomy.
- This complication led to mortality in the affected patients.
Findings:
- Thoracotomy in ECMO patients carries a high risk of fatal hemorrhage.
- Current anticoagulation strategies may be inadequate for managing surgical bleeding.
- The study underscores a critical gap in managing ECMO patients requiring invasive procedures.
Implications:
- Revision of anticoagulation protocols for ECMO patients undergoing surgery is urgently needed.
- Developing safer strategies for operative interventions in ECMO patients is paramount.
- Further research into optimal anticoagulation targets during ECMO and surgery is warranted.
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