J Korean Med Sci.  2013 Jun;28(6):962-964. 10.3346/jkms.2013.28.6.962.

Extracorporeal Membrane Oxygenation for Acute Life-Threatening Neurogenic Pulmonary Edema following Rupture of an Intracranial Aneurysm

• Hwang GJ
• Sheen SH
• Kim HS
• Lee HS
• Lee TH
• Gim GH
• Hwang SM
• Lee JJ

• KMID: 2158050
• DOI: http://doi.org/10.3346/jkms.2013.28.6.962

Abstract

Neurogenic pulmonary edema (NPE) leading to cardiopulmonary dysfunction is a potentially life-threatening complication in patients with central nervous system lesions. This case report describes a 28-yr woman with life-threatening fulminant NPE, which was refractory to conventional respiratory treatment, following the rupture of an aneurysm. She was treated successfully with extracorporeal membrane oxygenation (ECMO), although ECMO therapy is generally contraindicated in neurological injuries such as brain trauma and diseases that are likely to require surgical intervention. The success of this treatment suggests that ECMO therapy should not be withheld from patients with life-threatening fulminant NPE after subarachnoid hemorrhage.

Keyword

Extracorporeal Membrane Oxygenation; Pulmonary Edema; Subarachnoid Hemorrhage

MeSH Terms

Adult
Brain/radiography
Decompressive Craniectomy
Extracorporeal Membrane Oxygenation
Female
Humans
Intracranial Aneurysm/complications/*diagnosis
Pulmonary Edema/*diagnosis/etiology/therapy
Subarachnoid Hemorrhage/etiology
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Computed tomographic scan showing a hematoma with mass effect in the right frontal base, suggesting rupture of an anterior communicating artery aneurysm.

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  Fig. 2 Thoracic radiography: (A) severe pulmonary edema is evident, (B) the pulmonary edema had improved by the last day of extracorporeal membrane oxygenation treatment.

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