Anesth Pain Med.  2014 Oct;9(4):263-267. 10.0000/apm.2014.9.4.263.

Lung transplantation in a patient with massive pneumomediastinum following 66 days of awake extracorporeal membrane oxygenation support: A case report

• Kim JA
• Yang M
• Ahn HJ
• Lee EK
• Choi JY

• KMID: 2046866
• DOI: http://doi.org/10.0000/apm.2014.9.4.263

Abstract

In a 54-year-old man with interstitial lung disease associated with dermatomyositis, acute exacerbation of the disease had occurred and massive pneumothorax, pneumomediastinum and extensive subcutaneous emphysema were developed while waiting for lung transplantation. He was supported by awake extracorporeal membrane oxygenation (ECMO) for 66 days and bridged to lung transplantation, but mechanical ventilation was not done during ECMO period and induction period to avoid tension pneumothorax and cardiac tamponade. Notable points of this report are that the days of ECMO support were long, the type was awake ECMO, and positive pressure ventilation was not done during whole pretransplant period including anesthesia induction. The transplantation was done successfully and the patient was discharged 25 days after lung transplantation.

Keyword

Extracorporeal membrane oxygenation; Lung transplantation; Pneumomediastinum; Positive pressure ventilation

MeSH Terms

Anesthesia
Cardiac Tamponade
Dermatomyositis
Extracorporeal Membrane Oxygenation*
Humans
Lung Diseases, Interstitial
Lung Transplantation*
Mediastinal Emphysema*
Middle Aged
Pneumothorax
Positive-Pressure Respiration
Respiration, Artificial
Subcutaneous Emphysema