Venopulmonary ECMO as a bridge to lung transplantation using the ProtekDuo cannula
Presented During: Welcome Reception and Poster Competition | Sponsored by: TransMedics
Gainesville, FL
United States - Contact Me
My name is Mindaugas Rackauskas, MD, PhD, and I am a thoracic and lung transplant surgeon in the University of Florida Department of Surgery.
Friday, September 20, 2024: 5:00 PM - 6:30 PM
Omni King Edward Hotel
Description
Objective: Extracorporeal membrane oxygenation (ECMO) has been used as a bridge to lung transplantation in patients with end stage lung disease. Venovenous (VV) ECMO is the most commonly used mode of support in pre-lung transplant recipients. In certain patients who experience right ventricular dysfunction, venopulmonary ECMO is an excellent option to preserve RV function.
Methods: We retrospectively reviewed patients who were supported with venopulmonary ECMO using the ProtekDuo cannula in our institution (May 1, 2021, to March 14, 2024). Descriptive analysis, patient characteristics, ECMO outcomes, and survival were assessed. The primary outcome was mortality.
Results: 2 patients required ECMO due to COVID-19 fibrosis, 1 post bleomycin toxicity and 1 for interstitial lung disease with pulmonary hypertension. Mean age was 45.5 + 15.63, mean ECMO hours 1391.75 + 1239.01, mean hospital length of stay was 107.5 + 54.29 All 4 patients had right ventricular dysfunction. 3 (75%) patients were supported with venovenous ECMO before conversion to venopulmonary mode with mean of 17 + 13.2 days before development of the ventricular dysfunction. All patients received bilateral orthotopic lung transplant. One-year survival was 100% for all patients.
Conclusions: Venopulmonary extracorporeal membrane oxygenation can be safely used to bridge patients with end-stage lung disease to lung transplantation. Potential etiologies for right ventricular dysfunction include pulmonary hypertension and volume overload from return cannula during venovenous ECMO.
Authors
YURIY STUKOV (1), Mindaugas Rackauskas (2), Yuriy Stukov (3), Amir Emtiazjoo (4), Marc Maybauer (5)
Institutions
(1) The University of Florida, Gainesville, FL, (2) N/A, Gainesville, FL, (3) N/A, N/A, (4) University of Florida, Gainesville, FL, (5) Division of Critical Care Medicine, Department of Anesthesiology, University of Florida, Gainesville, FL
Methods: We retrospectively reviewed patients who were supported with venopulmonary ECMO using the ProtekDuo cannula in our institution (May 1, 2021, to March 14, 2024). Descriptive analysis, patient characteristics, ECMO outcomes, and survival were assessed. The primary outcome was mortality.
Results: 2 patients required ECMO due to COVID-19 fibrosis, 1 post bleomycin toxicity and 1 for interstitial lung disease with pulmonary hypertension. Mean age was 45.5 + 15.63, mean ECMO hours 1391.75 + 1239.01, mean hospital length of stay was 107.5 + 54.29 All 4 patients had right ventricular dysfunction. 3 (75%) patients were supported with venovenous ECMO before conversion to venopulmonary mode with mean of 17 + 13.2 days before development of the ventricular dysfunction. All patients received bilateral orthotopic lung transplant. One-year survival was 100% for all patients.
Conclusions: Venopulmonary extracorporeal membrane oxygenation can be safely used to bridge patients with end-stage lung disease to lung transplantation. Potential etiologies for right ventricular dysfunction include pulmonary hypertension and volume overload from return cannula during venovenous ECMO.
Authors
YURIY STUKOV (1), Mindaugas Rackauskas (2), Yuriy Stukov (3), Amir Emtiazjoo (4), Marc Maybauer (5)
Institutions
(1) The University of Florida, Gainesville, FL, (2) N/A, Gainesville, FL, (3) N/A, N/A, (4) University of Florida, Gainesville, FL, (5) Division of Critical Care Medicine, Department of Anesthesiology, University of Florida, Gainesville, FL