Document Detail


Endogenous carbon monoxide production: a rare and detrimental complication of extracorporeal membrane oxygenation.
MedLine Citation:
PMID:  19033779     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Extracorporeal membrane oxygenation (ECMO) is a technique that can support gas-exchange and cardiac function in patients with acute respiratory or cardiac failure that is not responsive to conservative treatment. ECMO is a high-risk procedure in critically ill patients and both technical and patient-related complications frequently occur. We report on a patient with end-stage pulmonary fibrosis (histiocytosis x), in whom ECMO was used as bridge to urgent lung transplantation. Respiratory insufficiency necessitating ECMO therapy was due to spontaneous pneumothorax with bronchopleural fistula. Access was initially made by femoral veno-venous canulation. Due to right heart failure, access was switched to veno-arterial using the two existing canulae as efferent system and implanting a third canula on the femoral artery using a graft. Despite marked hemodynamic improvement after this intervention, high flow rates creating high premembrane pressures were required to ensure oxygenation. High levels of carboxyhemoglobin (COHb) occurred, most likely due to massive mechanical hemolysis in the ECMO circuit. This may have had detrimental effects by further complicating tissue oxygenation. We recommend that COHb should routinely be checked in ECMO patients.
Authors:
Greet Hermans; Alexander Wilmer; Daniel Knockaert; Bart Meyns
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  54     ISSN:  1538-943X     ISO Abbreviation:  ASAIO J.     Publication Date:    2008 Nov-Dec
Date Detail:
Created Date:  2008-11-26     Completed Date:  2009-02-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  633-5     Citation Subset:  IM    
Affiliation:
Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals, Leuven, Belgium. Greet.Hermans@uz.kuleuven.ac.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Carbon Monoxide / blood*
Carboxyhemoglobin / biosynthesis
Extracorporeal Membrane Oxygenation / adverse effects*
Humans
Male
Pulmonary Fibrosis / surgery
Chemical
Reg. No./Substance:
630-08-0/Carbon Monoxide; 9061-29-4/Carboxyhemoglobin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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