Application of extracorporeal membrane oxygenation in the perioperative period of lung transplantation

Abstract

Objective: To investigate the application of extracorporeal membrane oxygenation (ECMO) in the perioperative period of lung transplantation, and summarize the experience. Methods: The clinical data of 19 patients receiving lung transplantation operation in Renmin Hospital of Wuhan University from December 2016 to December 2020 were retrospectively analyzed. Patients were divided into groups according to whether ECMO support was used, and their clinical data were compared. Results: Among the 19 patients, there were 5 cases of chronic obstructive pulmonary disease, 3 cases of bronchiectasis, 4 cases of pneumoconiosis, 4 cases of idiopathic pulmonary fibrosis, 1 case of connective tissue disease interstitial pulmonary fibrosis, 1 case of Kartagener syndrome, and 1 case of COVID-19 with advanced pulmonary fibrosis. Among the 10 patients in the non-ECMO group, 1 died during the operation, 1 died after abandoning treatment, and 1 was discharged after abandoning treatment. There were 9 patients in the ECMO group, 2 patients received ECMO bridged treatment before surgery, and the remaining 7 patients received ECMO adjuvant treatment after anesthesia. In the ECMO group, 1 patient died, 1 patient was discharged after abandoning treatment, and the rest patients were all improved and discharged after successful weaning of ECMO. The two groups only differed in the way of preoperative respiratory support (P=0.033). There were no significant differences in gender, age, preoperative assessment, surgical process, length of hospital stay, ICU stay, postoperative multi-drug resistant organism infection, and outcome. Conclusion: ECMO is an important auxiliary tool during the perioperative period of lung transplantation. The use of ECMO did not increase the risk of postoperative infection with multidrug-resistant bacteria, nor did it lead to an increase in mortality. In the other hand, the choice of preoperative respiratory support method has reference for perioperative patients whether to use ECMO. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.