Anesth Pain Med.  2019 Jan;14(1):48-53. 10.17085/apm.2019.14.1.48.

Successful case of veno-venous extracorporeal membrane oxygenation in an abdominal trauma patient: A case report

• Kim JH
• Kim JY
• Park S

• KMID: 2434199
• DOI: http://doi.org/10.17085/apm.2019.14.1.48

Abstract

A 37-year-old male visited the hospital with multiple trauma after traffic accident. Fractures of ribs, left femur, and right humerus and spleen rupture with hemoperitoneum were founded on image studies. He was moved to operation room and general anesthesia was performed for splenectomy. During the operation, excessive high peak inspiratory pressure was observed. After abdominal closure, hypoxia, hypercapnia, and respiratory acidosis were worsened. Veno-venous extracorporeal membrane oxygenation (ECMO) was initiated after the operation. Status of the patient were improved after the application of ECMO. The patient was discharged without significant complication. Despite of several limitations in applying ECMO to patients with abdominal compartment syndrome (ACS) and multiple trauma, severe pulmonary dysfunction in ACS patients may be rescued without open abdomen treatment.

Keyword

Adult respiratory distress syndrome; Extracorporeal membrane oxygenation; Hemoperitoneum; Intra-abdominal hypertension; Multiple trauma

MeSH Terms

Abdomen
Accidents, Traffic
Acidosis, Respiratory
Adult
Anesthesia, General
Anoxia
Extracorporeal Membrane Oxygenation*
Femur
Hemoperitoneum
Humans
Humerus
Hypercapnia
Intra-Abdominal Hypertension
Male
Multiple Trauma
Respiratory Distress Syndrome, Adult
Ribs
Rupture
Spleen
Splenectomy

Figure

• 

  Fig. 1 Abdominal computed tomography image demostrated hemoperitoneum and the American Association for the Surgery of Trauma grade V spleen injury.

• 

  Fig. 2 Chest radiograph after the operation showed bilateral infiltration of lungs.

• 

  Fig. 3 Chest radiograph one day after extracorporeal membrane oxygenation application showed improved state of lung infiltration.

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