Independent ventilation and ECMO for severe unilateral pulmonary edema after SLT for primary pulmonary hypertension.
Single lung transplantation (SLT) is now accepted therapy for selected cases of severe pulmonary hypertension. A recognized complication is the postoperative development of reperfusion edema in the graft, a potentially fatal cause of respiratory failure. Because reperfusion edema may be a reversible process, temporizing support measures can be life-saving. We report the case of a 48-year-old woman who developed severe reperfusion edema following right SLT for primary (unexplained) pulmonary hypertension. Extracorporeal membrane oxygenation (ECMO) was instituted. Independent lung ventilation was later begun and resulted in markedly improved oxygenation allowing withdrawal of ECMO. We conclude that reperfusion edema following SLT for pulmonary hypertension may be uniquely amenable to treatment with independent lung ventilation and ECMO if needed.
Badesch
D B
DB
Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences Center, Denver, USA.
Zamora
M R
MR
Jones
S
S
Campbell
D W
DW
Fullerton
D A
DA
D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery*; D008168:Lung / Q000000981:diagnostic imaging; D016040:Lung Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011859:Radiography; D012121:Respiration, Artificial