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Journal of Artificial Organs

, Volume 20, Issue 4, pp 377–380 | Cite as

Successful management of prolonged venovenous extracorporeal membrane oxygenation in an octogenarian

  • Masami TakagakiEmail author
  • Hiroki YamaguchiEmail author
  • Shinichi Mitsuyama
  • Tasuku Kadowaki
  • Takeshi Ando
Case Report Artificial Lung / ECMO

Abstract

Venovenous extracorporeal membrane oxygenation is now an established treatment for acute respiratory distress syndrome. However, this treatment remains rare in octogenarians and is associated with poor outcomes. An 81-year-old man with a history of chronic obstructive pulmonary disease and heavy smoking underwent mitral and tricuspid valve repair and the Maze procedure for mitral and tricuspid regurgitation and paroxysmal atrial fibrillation. Although he was extubated the following day, his postoperative course was complicated with pneumonia followed by acute respiratory distress syndrome. He was reintubated on day 7. Ratio of partial pressure of arterial oxygen to fraction of inspired oxygen continuously dropped to less than 100 mmHg, and venovenous extracorporeal membrane oxygenation support was induced on day 18. His lung condition showed slow and steady recovery, and he was successfully weaned from mechanical support on day 44 (total support, 27 days). Bleeding complication from tracheotomy (day 31) due to disseminated intravascular coagulation was successfully managed using recombinant human soluble thrombomodulin. He was ambulatory and discharged to a nursing facility without tracheotomy on day 172. Proper extracorporeal membrane oxygenation management, while challenging to keep the elderly patient away from further complications, saved an 81-year-old patient.

Keywords

Extracorporeal membrane oxygenation Octogenarian Acute respiratory distress syndrome Prolonged respiratory failure 

Notes

Acknowledgements

The authors would like to thank Enago (http://www.enago.jp) for the English language review.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© The Japanese Society for Artificial Organs 2017

Authors and Affiliations

  1. 1.Department of Cardiovascular SurgeryShowa University Koto Toyosu HospitalTokyoJapan

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