title: [Case report of anesthesia with veno-veno extracorporeal membrane oxygenation (V-V ECMO) during one-lung ventilation for acute respiratory distress syndrome (ARDS) complicated with severe sepsis due to spontaneous esophageal rupture].
abstract: A 55-year-old man was transferred to our hospital with spontaneous esophageal rupture. An emergency operation of mediastinum drainage by thoracotomy was performed. On postoperative day 8, he had new abcesses located at the upper mediastinum around the esophagus, and required another operation. But one-lung ventilation for the operation was difficult, because of profound hypoxia caused by the acute respiratory distress syndrome (ARDS) with severe sepsis. Therefore we introduced V-V ECMO for the treatment of severe hypoxia and could anesthetize him safely during surgical operation. Intraoperative and post-operative hemodynamics was stable. His respiratory condition improved, and he was weaned from V-V ECMO. Unfortunately, postoperative day 11, he died because of sudden intrathoracic bleeding from the thoracic aorta which might have been infected by the severe mediastinitis.
authors.affiliation: Department of Emergency & Critical Care Medicine, Nippon Medical School, Tokyo 113-8602.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ono
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ohta
authors.forename: Gaku
authors.initials: G
authors.lastname: Matsumoto
authors.forename: Shiei
authors.initials: S
authors.lastname: Kim
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yokota
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Sakamoto
mesh_terms: D004630:Emergencies; D004935:Esophageal Diseases / Q000150:complications* / Q000601:surgery; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation* / Q000379:methods; D017809:Fatal Outcome; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D061810:One-Lung Ventilation; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000628:therapy*; D012422:Rupture, Spontaneous; D018805:Sepsis / Q000209:etiology*; D012720:Severity of Illness Index