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Early venovenous extracorporeal membrane oxygenation for idiopathic post-pneumonectomy pulmonary edema

Charles Moulin, Philippe Girard, Agathe Seguin-Givelet, Konstantinos Zannis, Laurent Tric, Jean-Luc Leguillou, Thibault Vieira, Dominique Gossot, Christian Lamer
European Respiratory Journal 2020 56: 4093; DOI: 10.1183/13993003.congress-2020.4093
Charles Moulin
1Department of Critical Care Medicine, Institut Mutualiste Montsouris, Paris, France., Paris, France
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  • For correspondence: charles.moulin@outlook.com
Philippe Girard
2Thoracic Department, Institut Mutualiste Montsouris, Paris, France., Paris, France
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Agathe Seguin-Givelet
2Thoracic Department, Institut Mutualiste Montsouris, Paris, France., Paris, France
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Konstantinos Zannis
3Department of Cardiac Surgery, Institut Mutualiste Montsouris, Paris, France., Paris, France
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Laurent Tric
1Department of Critical Care Medicine, Institut Mutualiste Montsouris, Paris, France., Paris, France
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Jean-Luc Leguillou
1Department of Critical Care Medicine, Institut Mutualiste Montsouris, Paris, France., Paris, France
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Thibault Vieira
2Thoracic Department, Institut Mutualiste Montsouris, Paris, France., Paris, France
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Dominique Gossot
2Thoracic Department, Institut Mutualiste Montsouris, Paris, France., Paris, France
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Christian Lamer
1Department of Critical Care Medicine, Institut Mutualiste Montsouris, Paris, France., Paris, France
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Abstract

Introduction: Idiopathic post-pneumonectomy pulmonary edema (iPPE) is a rare but extremely severe complication of thoracic surgery. Mortality can reach 100 % especially after right pneumonectomy.

Objective: This study aimed to report the results of a strategy of early venovenous extracorporeal membrane oxygenation (vvECMO) in iPPE and to compare the results with those observed during a previous 6 years control period.

Methods: Since October 2010 , all patients diagnosed as iPPE were treated with early vvECMO associated with ultraprotective mechanical ventilation. Outcomes were compared with iPPE patients treated with conventional mechanical ventilation over the 2004-2010 period.

Results: Between October 2010 and December 2017, 150 pneumonectomies were performed ; 6 (mean age = 59.6 y ; 4 right pneumonectomies) patients developped iPPE and were treated with early vvECMO (mean time to ECMO = 3 days after surgery, range: 2 to 6 days) Mean durations of ECMO, mechanical ventilation and ICU stay were 8.6, 31.3, 39.2 days respectively. All patients survived and could be discharged from hospital. Four patients experienced a complication directly related to the vvECMO (major hemorrhage, n = 1 ; bacteremia with septic shock, n = 1 ; deep venous thrombosis, n = 2). During the control period 5 iPPE (mean age = 69 yrs ; 4 right pneumonectomies) occurred among 218 patients. All patients died during their ICU stay after a mean duration of 8.5 days.

Conclusion: This study suggests that early vvECMO should be considered as a life-saving therapy in iPPE .

  • Lung cancer
  • Acute respiratory failure
  • ARDS (Acute Respiratory Distress Syndrome)

Footnotes

Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4093.

This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2020
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Early venovenous extracorporeal membrane oxygenation for idiopathic post-pneumonectomy pulmonary edema
Charles Moulin, Philippe Girard, Agathe Seguin-Givelet, Konstantinos Zannis, Laurent Tric, Jean-Luc Leguillou, Thibault Vieira, Dominique Gossot, Christian Lamer
European Respiratory Journal Sep 2020, 56 (suppl 64) 4093; DOI: 10.1183/13993003.congress-2020.4093

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Early venovenous extracorporeal membrane oxygenation for idiopathic post-pneumonectomy pulmonary edema
Charles Moulin, Philippe Girard, Agathe Seguin-Givelet, Konstantinos Zannis, Laurent Tric, Jean-Luc Leguillou, Thibault Vieira, Dominique Gossot, Christian Lamer
European Respiratory Journal Sep 2020, 56 (suppl 64) 4093; DOI: 10.1183/13993003.congress-2020.4093
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