title: [Venovenous extracorporeal membrane oxygenation in an elderly patient with severe respiratory failure--report of a case].
abstract: A 69-year-old woman, who developed acute respiratory distress syndrome (ARDS) after coronary artery bypass grafting, underwent venovenous extracorporeal membrane oxygenation (V-V ECMO) because conventional ventilatory support was ineffective. We used a covalently bonded heparin surface ECMO system, including an artificial lung, a centrifugal pump, cannulas, tubing and connectors, that was maintained with low-dose systemic heparinization, the patient was weaned from ECMO after 186 hours. During ECMO, her platelet count was about half of the initial level and markedly elevated thrombin-antithrombin complex (TAT), plasmin-alpha 2 plasmin inhibitor complex (PIC) and D-dimer were decreased by the use of heparin and protease inhibitors. V-V ECMO seems to be useful even in patients with severe adult respiratory failure and can be performed safely if a heparin covalent circuit is applied.
authors.affiliation: Department of Cardiovascular Surgery, Niigata Kobari Hospital, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Maruyama
authors.forename: H
authors.initials: H
authors.lastname: Ohzeki
authors.forename: M
authors.initials: M
authors.lastname: Shinonaga
authors.forename: M
authors.initials: M
authors.lastname: Ueno
authors.forename: S
authors.initials: S
authors.lastname: Eguch
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D011183:Postoperative Complications; D011480:Protease Inhibitors / Q000008:administration & dosage; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000628:therapy*
chemical_list: D011480:Protease Inhibitors; D006493:Heparin