Anesthesia & Clinical Research
Open Access

Abstract

Use of Venovenous Extracorporeal Membrane Oxygenation to Anticipate Difficult One Lung Ventilation in Thoracic surgery

Perdomo JM, Gomar C, Navarro R, Mata MT and Gimferrer J

Thoracic surgery may create clinical scenarios where the maintenance of a correct oxygenation and ventilation
may be challenging and could lead to incomplete surgery despite cardiovascular stability. Recently, venovenous
extracorporeal membrane oxygenation (V-V ECMO) has emerged as an alternative to manage these situations
when neither one lung ventilation (OLV) nor other ventilation and oxygenation techniques are feasible or sufficient
due to associated lung disease or difficult airway. Here, we report the use of V-V ECMO support in two cases of
thoracic surgery in which difficult OLV was anticipated. From the experience gathered in these two cases, we
recommend to consider the use of V-V ECMO in selected patients with compromised airway or significant disease of
the contralateral surgical hemithorax where conventional options cannot guarantee a correct ventilation and
oxygenation. However, V-V ECMO use is not free of complications, being bleeding one of the most frequent and
severe problems in surgical patients, which must be thoroughly prevented and treated by the anesthesiologist, the
surgeon and the perfusionist.