Korean J Thorac Cardiovasc Surg.  2015 Aug;48(4):289-293. 10.5090/kjtcs.2015.48.4.289.

Right Heart Failure during Veno-Venous Extracorporeal Membrane Oxygenation for H1N1 Induced Acute Respiratory Distress Syndrome: Case Report and Literature Review

• Lee SH
• Jung JS
• Chung JH
• Lee KH
• Kim HJ
• Son HS
• Sun K

• KMID: 2382275
• DOI: http://doi.org/10.5090/kjtcs.2015.48.4.289

Abstract

A 38-year-old male was admitted with symptoms of upper respiratory infection. Despite medical treatment, his symptoms of dyspnea and anxiety became aggravated, and bilateral lung infiltration was noted on radiological imaging studies. His hypoxemia failed to improve even after the application of endotracheal intubation with mechanical ventilator care, and we therefore decided to initiate venovenous extracorporeal membrane oxygenation (VV ECMO) for additional pulmonary support. On his twentieth day of hospitalization, hypotension and desaturation (arterial saturated oxygen <85%) developed, and right ventricular failure was confirmed by two-dimensional echocardiography. Therefore, we changed from VV ECMO to venoarteriovenous (VAV) ECMO, and the patient ultimately recovered. In this case, right ventricular dysfunction and volume overloading were induced by long-term VV ECMO therapy, and we successfully treated these conditions by changing to VAV ECMO.

Keyword

Acute respiratory distress syndrome (ARDS); Right ventricular dysfunction; Extracorporeal membrane oxygenation

MeSH Terms

Adult
Anoxia
Anxiety
Dyspnea
Echocardiography
Extracorporeal Membrane Oxygenation*
Heart Failure*
Heart*
Hospitalization
Humans
Hypotension
Intubation, Intratracheal
Lung
Male
Oxygen
Respiratory Distress Syndrome, Adult*
Ventilators, Mechanical
Ventricular Dysfunction, Right
Oxygen