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Published on: February 26, 2013
Cryotherapy: A Safe Approach to Pulmonary Hemorrhage During VV-ECMO
Adam Green1, Nitin Puri1, Michael Kouch1
1Cooper Medical School of Rowan University, Camden, NJ, USA.
Abstract:
The number of hospitals with veno-venous extracorporeal membrane oxygenation (VV-ECMO) capabilities is expanding. To support an ECMO program, centers must be equipped to handle associated complications such as pulmonary hemorrhage. We describe a case series of 4 patients with life-threatening pulmonary bleeding and central airway obstruction. A therapeutic approach of anticoagulation cessation coupled with cryoextraction via flexible bronchoscopy led to successful restoration of airway patency without any adverse events. A low threshold to stop anticoagulation with a strong consideration of bronchoscopy with cryotherapy for pulmonary toilet should be done in patients with pulmonary hemorrhage during VV-ECMO.
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