초록접수 현황
| 15F-159 | 구연 발표 |
The Feasibility of ECMO in the High Risk Thoracic Surgery
김도형¹, 손봉수¹, 김창완¹, 안효영², 조정수², 이호석², 김영대²
부산대학교 의과대학 양산부산대학교병원 흉부외과학교실¹, 부산대학교 부산대학교병원 흉부외과²
Background : Extracorporeal membrane oxygenation (ECMO) is being extended to a wide variety of clinical fields. However, it does not gained general consent for surgical assist device in the variant clinical field of thoracic surgery. In this study we assess the utility of ECMO in the management of thoracic surgery.
¹¹
Methods : Between January 2011 and August 2015, 20 patients underwent ECMO for assist of thoracic surgery. We retrospectively analyzed the clinical data and evaluated the feasibility of ECMO.
Results : In nine cases, ECMO was electively used to facilitate respiration and promote stability during trachea surgery. In seven cases emergency ECMO was used in response to cardiac or respiratory arrest. In five cases, thoracic operation was performed in the state that ECMO had been inserted due to respiratory or cardiac failure. 12 patients were not able to stop ECMO after operation. 8 cases due to respiratory support (VV ECMO), and 4 cases for cardiac supports (VA ECMO).. Of 12 cases, Three cases were not impossibel to wean ECMO. There were 5 mortality (25%,5/20), the causes of death were 3 arrest related problems and 2 medical problems (sepsis, ARDS), Especially, there was no mortality in the electively inserted group, and there was only one delayed mortality(20%,1/5) in the ECMO using group. However, the mortality was high (42.8%,3/7) in arrest group.
Conclusion : ECMO is useful during thoracic surgery in patients at high risk of respiratory or cardiac failure ECMO confers a safer environment during thoracic surgery, and its complication rate is acceptable.
¹¹
Methods : Between January 2011 and August 2015, 20 patients underwent ECMO for assist of thoracic surgery. We retrospectively analyzed the clinical data and evaluated the feasibility of ECMO.
Results : In nine cases, ECMO was electively used to facilitate respiration and promote stability during trachea surgery. In seven cases emergency ECMO was used in response to cardiac or respiratory arrest. In five cases, thoracic operation was performed in the state that ECMO had been inserted due to respiratory or cardiac failure. 12 patients were not able to stop ECMO after operation. 8 cases due to respiratory support (VV ECMO), and 4 cases for cardiac supports (VA ECMO).. Of 12 cases, Three cases were not impossibel to wean ECMO. There were 5 mortality (25%,5/20), the causes of death were 3 arrest related problems and 2 medical problems (sepsis, ARDS), Especially, there was no mortality in the electively inserted group, and there was only one delayed mortality(20%,1/5) in the ECMO using group. However, the mortality was high (42.8%,3/7) in arrest group.
Conclusion : ECMO is useful during thoracic surgery in patients at high risk of respiratory or cardiac failure ECMO confers a safer environment during thoracic surgery, and its complication rate is acceptable.
책임저자: 김도형
부산대학교 의과대학 양산부산대학교병원 흉부외과학교실
연락처 : 김도형, Tel: 055-360-2127 , E-mail : yumccs@nate.com
