title: Central extracorporeal membrane oxygenation requiring pulmonary arterial venting after near-drowning.
abstract: Extracorporeal membrane oxygenation (ECMO) is an effective respiratory and circulatory support in patients in refractory cardiogenic shock or cardiac arrest. Peripheral ECMO sometimes requires left heart drainage; however, few reports state that pulmonary arterial (PA) venting is required during ECMO support. We present a case of a 14-year-old boy who required PA venting during ECMO support after resuscitation from near-drowning in freshwater. A biventricular assist device with an oxygenator implantation was intended on day 1; however, we were unable to proceed because of increasing of pulmonary vascular resistance from the acute lung injury. Central ECMO with PA venting was then performed. On day 13, central ECMO was converted to biventricular assist device with an oxygenator, which was removed on day 16. This case suggests that PA venting during ECMO support may be necessary in some cases of respiratory and circulatory failure with high pulmonary vascular resistance after near-drowning.
authors.affiliation: Department of Cardiothoracic Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Kimura
authors.affiliation: Department of Cardiothoracic Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Kinoshita
authors.affiliation: Department of Cardiovascular Surgery, Shimane University, Shimane, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Fujimoto
authors.affiliation: Department of Cardiovascular Surgery, Gunma Children's Medical Center, Gunma, Japan.
authors.forename: Arata
authors.initials: A
authors.lastname: Murakami
authors.affiliation: Department of Pediatrics, The University of Tokyo, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shindo
authors.affiliation: Department of Medical Engineering, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Kashiwa
authors.affiliation: Department of Cardiothoracic Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Ono
mesh_terms: D000293:Adolescent; D004322:Drainage; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006353:Heart-Assist Devices; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000628:therapy; D008297:Male; D015701:Near Drowning / Q000628:therapy*; D011651:Pulmonary Artery / Q000601:surgery; D014655:Vascular Resistance