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e-Article

Unusual severe hypoxemia due to unilateral pulmonary edema after conventional cardiopulmonary bypass salvaged by veno-venous extracorporeal membrane oxygenation: a case report
Document Type
article
Source
JA Clinical Reports, Vol 9, Iss 1, Pp 1-5 (2023)
Subject
Cardiopulmonary bypass
Re-expansion pulmonary edema
Unilateral pulmonary edema
Veno-venous extracorporeal membrane oxygenation
Anesthesiology
RD78.3-87.3
Medical emergencies. Critical care. Intensive care. First aid
RC86-88.9
Language
English
ISSN
2363-9024
Abstract
Abstract Background We report a case in which veno-venous extracorporeal membrane oxygenation (V-V ECMO) saved the life of a patient who developed severe hypoxemia due to unusual unilateral pulmonary edema (UPE) after cardiopulmonary bypass (CPB). Case presentation A 69-year-old man underwent aortic valve replacement and coronary artery bypass grafting. Following uneventful weaning off CPB, he developed severe hypoxemia. The ratio of arterial oxygen tension to inspired oxygen fraction (PaO2/FiO2) decreased from 301 mmHg 5 min after CPB to 42 mmHg 90 min after CPB. A chest X-ray revealed right-sided UPE. Immediately established V-V ECMO increased PaO2/FiO2 to 170 mmHg. Re-expansion pulmonary edema (REPE) was likely, as the right lung remained collapsed during CPB following the accidental opening of the right chest cavity during graft harvesting. Conclusions V-V ECMO was effective in improving oxygenation and saving the life of a patient who had fallen into unilateral REPE unusually developing after conventional CPB.