- Surgery
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Risk factors for intensive care unit readmission after lung transplantation: a retrospective cohort study
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Hye-Bin Kim, Sungwon Na, Hyo Chae Paik, Hyeji Joo, Jeongmin Kim
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Acute Crit Care. 2021;36(2):99-108. Published online April 5, 2021
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DOI: https://doi.org/10.4266/acc.2020.01144
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Abstract
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- Background
Lung transplantation (LT) is an accepted therapeutic modality for end-stage lung disease patients. Intensive care unit (ICU) readmission is a risk factor for mortality after LT, for which consistent risk factors have not been elucidated. Thus, we investigated the risk factors for ICU readmission during index hospitalization after LT, particularly regarding the posttransplant condition of LT patients.
Methods In this retrospective study, we investigated all adult patients undergoing LT between October 2012 and August 2017 at our institution. We collected perioperative data from electronic medical records such as demographics, comorbidities, laboratory findings, ICU readmission, and in-hospital mortality.
Results We analyzed data for 130 patients. Thirty-two patients (24.6%) were readmitted to the ICU 47 times during index hospitalization. At the initial ICU discharge, the Sequential Organ Failure Assessment (SOFA) score (odds ratio [OR], 1.464; 95% confidence interval [CI], 1.083−1.978; P=0.013) and pH (OR, 0.884; 95% CI, 0.813−0.962; P=0.004; when the pH value increases by 0.01) were related to ICU readmission using multivariable regression analysis and were still significant after adjusting for confounding factors. Thirteen patients (10%) died during the hospitalization period, and the number of ICU readmissions was a significant risk factor for in-hospital mortality. The most common causes of ICU readmission and in-hospital mortality were infection-related.
Conclusions The SOFA score and pH were associated with increased risk of ICU readmission. Early postoperative management of these factors and thorough posttransplantation infection control can reduce ICU readmission and improve the prognosis of LT patients.
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Citations
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- The association of the Sequential Organ Failure Assessment score at intensive care unit discharge with intensive care unit readmission in the cardiac intensive care unit
Yonghoon Shin, Ji Hoon Jang, Ryoung-Eun Ko, Soo Jin Na, Chi Ryang Chung, Ki Hong Choi, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang European Heart Journal: Acute Cardiovascular Care.2024;[Epub] CrossRef - Cardiothoracic Transplant Anesthesia: Selected Highlights: Part I—Lung Transplantation
Andrew M. Courtwright, Jagan Devarajan, Ashley Virginia Fritz, Archer Kilbourne Martin, Barbara Wilkey, Sudhakar Subramani, Christopher M. Cassara, Justin N. Tawil, Andrea N. Miltiades, Michael L. Boisen, Brandi A. Bottiger, Angela Pollak, Theresa A. Gelz Journal of Cardiothoracic and Vascular Anesthesia.2023; 37(6): 884. CrossRef - Status and Risk Factors in Patients Requiring Unplanned Intensive Care Unit Readmission Within 48 Hours: A Retrospective Propensity-Matched Study in China
Yan-Ling Yin, Mei-Rong Sun, Kun Zhang, Yu-Hong Chen, Jie Zhang, Shao-Kun Zhang, Li-Li Zhou, Yan-Shuo Wu, Peng Gao, Kang-Kang Shen, Zhen-Jie Hu Risk Management and Healthcare Policy.2023; Volume 16: 383. CrossRef - Comment on “Risk factors for intensive care unit readmission after lung transplantation: a retrospective cohort study”
Maida Qazi, Mahnoor Amin Acute and Critical Care.2023; 38(2): 234. CrossRef - Reply to comment on “Risk factors for intensive care unit readmission after lung transplantation: a retrospective cohort study”
Hye-Bin Kim, Sungwon Na, Hyo Chae Paik, Hyeji Joo, Jeongmin Kim Acute and Critical Care.2023; 38(2): 236. CrossRef - Predicting outcomes, describing complications and optimising rehabilitation in patients undergoing lung transplantation
Massimiliano Polastri, Gian Maria Paganelli International Journal of Therapy and Rehabilitation.2023; 30(10): 1. CrossRef
- Thoracic Surgery
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Extracorporeal Membrane Oxygenation Bridge to Lung Transplantation in a Patient with Hermansky-Pudlak Syndrome and Progressive Pulmonary Fibrosis
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Wooho Sim, Song Yee Kim, Jinu Han, Tyler Hyungtaek Rim, Jin Gu Lee, Hyo Chae Paik, Moo Suk Park
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Acute Crit Care. 2019;34(1):95-98. Published online February 28, 2019
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DOI: https://doi.org/10.4266/acc.2018.00402
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5,329
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Citations
Citations to this article as recorded by
- Hermansky–Pudlak syndrome pulmonary fibrosis: a rare inherited interstitial lung disease
Tadafumi Yokoyama, Bernadette R. Gochuico European Respiratory Review.2021; 30(159): 200193. CrossRef - Selection Criteria for Lung Transplantation: Controversies and New Developments
Hanne Beeckmans, Saskia Bos, Robin Vos Seminars in Respiratory and Critical Care Medicine.2021; 42(03): 329. CrossRef - Hermansky–Pudlak syndrome: Mutation update
Marjan Huizing, May C. V. Malicdan, Jennifer A. Wang, Hadass Pri‐Chen, Richard A. Hess, Roxanne Fischer, Kevin J. O'Brien, Melissa A. Merideth, William A. Gahl, Bernadette R. Gochuico Human Mutation.2020; 41(3): 543. CrossRef - Hermansky-Pudlak syndrome-associated pneumothorax with rapid progression of respiratory failure: a case report
Yukari Kato, Motoyasu Kato, Hiroaki Ihara, Eri Hayakawa, Kohei Shibayama, Keita Miura, Tomoko Yamada, Yoichiro Mitsuishi, Takehito Shukuya, Jun Ito, Takeshi Matsunaga, Tadashi Sato, Kenji Suzuki, Kazuhisa Takahashi BMC Pulmonary Medicine.2020;[Epub] CrossRef
- Pulmonary
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Critical Care before Lung Transplantation
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Jin Gu Lee, Moo Suk Park, Su Jin Jeong, Song Yee Kim, Sungwon Na, Jeongmin Kim, Hyo Chae Paik
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Acute Crit Care. 2018;33(4):197-205. Published online November 30, 2018
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DOI: https://doi.org/10.4266/acc.2018.00367
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8,042
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Abstract
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- Lung transplantation is widely accepted as the only viable treatment option for patients with end-stage lung disease. However, the imbalance between the number of suitable donor lungs available and the number of possible candidates often results in intensive care unit (ICU) admission for the latter. In the ICU setting, critical care is essential to keep these patients alive and to successfully bridge to lung transplantation. Proper management in the ICU is also one of the key factors supporting long-term success following transplantation. Critical care includes the provision of respiratory support such as mechanical ventilation (MV) and extracorporeal life support (ECLS). Accordingly, a working knowledge of the common critical care issues related to these unique patients and the early recognition and management of problems that arise before and after transplantation in the ICU setting are crucial for long-term success. In this review, we discuss the management and selection of candidates for lung transplantation as well as existing respiratory support strategies that involve MV and ECLS in the ICU setting.
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Citations
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- Optimizing the prelung transplant candidate
John Pagteilan, Scott Atay Current Opinion in Organ Transplantation.2024; 29(1): 37. CrossRef - Awakening in extracorporeal membrane oxygenation as a bridge to lung transplantation
Su Hwan Lee Acute and Critical Care.2022; 37(1): 26. CrossRef - Recipient Management before Lung Transplantation
Hyoung Soo Kim, Sunghoon Park Journal of Chest Surgery.2022; 55(4): 265. CrossRef - Outcomes of Patients on the Lung Transplantation Waitlist in Korea: A Korean Network for Organ Sharing Data Analysis
Hye Ju Yeo, Dong Kyu Oh, Woo Sik Yu, Sun Mi Choi, Kyeongman Jeon, Mihyang Ha, Jin Gu Lee, Woo Hyun Cho, Young Tae Kim Journal of Korean Medical Science.2022;[Epub] CrossRef - Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
Nam Eun Kim, Ala Woo, Song Yee Kim, Ah Young Leem, Youngmok Park, Se Hyun Kwak, Seung Hyun Yong, Kyungsoo Chung, Moo Suk Park, Young Sam Kim, Ha Eun Kim, Jin Gu Lee, Hyo Chae Paik, Su Hwan Lee Respiratory Research.2021;[Epub] CrossRef
- Pulmonary
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Critical Care after Lung Transplantation
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Song Yee Kim, Su Jin Jeong, Jin Gu Lee, Moo Suk Park, Hyo Chae Paik, Sungwon Na, Jeongmin Kim
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Acute Crit Care. 2018;33(4):206-215. Published online November 30, 2018
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DOI: https://doi.org/10.4266/acc.2018.00360
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16,529
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Abstract
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- Since the first successful lung transplantation in 1983, there have been many advances in the field. Nevertheless, the latest data from the International Society for Heart and Lung Transplantation revealed that the risk of death from transplantation is 9%. Various aspects of postoperative management, including mechanical ventilation, could affect intensive care unit stay, hospital stay, and immediate postoperative morbidity and mortality. Complications such as reperfusion injury, graft rejection, infection, and dehiscence of anastomosis increase fatal adverse side effects immediately after surgery. In this article, we review the possible immediate complications after lung transplantation and summarize current knowledge on prevention and treatment.
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Citations
Citations to this article as recorded by
- Aspergillus Galactomannan Titer as a Diagnostic Marker of Invasive Pulmonary Aspergillosis in Lung Transplant Recipients: A Single-Center Retrospective Cohort Study
Eun-Young Kim, Seung-Hyun Yong, Min-Dong Sung, A-La Woo, Young-Mok Park, Ha-Eun Kim, Su-Jin Jung, Song-Yee Kim, Jin-Gu Lee, Young-Sam Kim, Hyo-Chae Paik, Moo-Suk Park Journal of Fungi.2023; 9(5): 527. CrossRef - Nontuberculous mycobacterial infection after lung transplantation: A single-center experience in South Korea
Youngmok Park, Nam Eun Kim, Se Hyun Kwak, Moo Suk Park, Su Jin Jeong, Jin Gu Lee, Hyo Chae Paik, Song Yee Kim, Young Ae Kang Journal of Microbiology, Immunology and Infection.2022; 55(1): 123. CrossRef - Medical Complications of Lung Transplantation
Moo Suk Park Journal of Chest Surgery.2022; 55(4): 338. CrossRef - Roles of electrical impedance tomography in lung transplantation
Hui Jiang, Yijiao Han, Xia Zheng, Qiang Fang Frontiers in Physiology.2022;[Epub] CrossRef - Perioperative anidulafungin combined with triazole prophylaxis for the prevention of early invasive candidiasis in lung transplant recipients
Emily Sartain, Kelly Schoeppler, Barrett Crowther, Joshua B. Smith, Maheen Z. Abidi, Todd J. Grazia, Mark Steele, Terri Gleason, Krista Porter, Alice Gray Transplant Infectious Disease.2021;[Epub] CrossRef - The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea
Yae-Jee Baek, Yun-Suk Cho, Moo-Hyun Kim, Jong-Hoon Hyun, Yu-Jin Sohn, Song-Yee Kim, Su-Jin Jeong, Moo-Suk Park, Jin-Gu Lee, Hyo-Chae Paik Journal of Fungi.2021; 7(8): 639. CrossRef - Panel-Reactive and Donor-Specific Antibodies before Lung Transplantation can Affect Outcomes in Korean Patients Receiving Lung Transplantation
Sung Woo Moon, Moo Suk Park, Jin Gu Lee, Hyo Chae Paik, Young Tae Kim, Hyun Joo Lee, Samina Park, Sun Mi Choi, Do Hyung Kim, Woo Hyun Cho, Hye Ju Yeo, Seung-il Park, Se Hoon Choi, Sang-Bum Hong, Tae Sun Shim, Kyung-Wook Jo, Kyeongman Jeon, Byeong-Ho Jeong Yonsei Medical Journal.2020; 61(7): 606. CrossRef - A proof-of principal study using phase-contrast imaging for the detection of large airway pathologies after lung transplantation
Stephan Umkehrer, Carmela Morrone, Julien Dinkel, Laura Aigner, Maximilian F. Reiser, Julia Herzen, Ali Ö. Yildirim, Franz Pfeiffer, Katharina Hellbach Scientific Reports.2020;[Epub] CrossRef
- Pulmonary
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Feasibility of Immediate in-Intensive Care Unit Pulmonary Rehabilitation after Lung Transplantation: A Single Center Experience
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Joo Han Song, Ji-Eun Park, Sang Chul Lee, Sarang Kim, Dong Hyung Lee, Eun Kyoung Kim, Song Yee Kim, Ji Cheol Shin, Jin Gu Lee, Hyo Chae Paik, Moo Suk Park
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Acute Crit Care. 2018;33(3):146-153. Published online August 31, 2018
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DOI: https://doi.org/10.4266/acc.2018.00129
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6,347
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Abstract
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- Background
Physical function may influence perioperative outcomes of lung transplantation. We investigated the feasibility of a pulmonary rehabilitation program initiated in the immediate postoperative period at an intensive care unit (ICU) for patients who underwent lung transplantation.
Methods We retrospectively evaluated 22 patients who received pulmonary rehabilitation initiated in the ICU within 2 weeks after lung transplantation at our institution from March 2015 to February 2016. Levels of physical function were graded at the start of pulmonary rehabilitation and then weekly throughout rehabilitation according to criteria from our institutional pulmonary rehabilitation program: grade 1, bedside (G1); grade 2, dangling (G2); grade 3, standing (G3); and grade IV, gait (G4).
Results The median age of patients was 53 years (range, 25 to 73 years). Fourteen patients (64%) were males. The initial level of physical function was G1 in nine patients, G2 in seven patients, G3 in four patients, and G4 in two patients. Patients started pulmonary rehabilitation at a median of 7.5 days (range, 1 to 29 days) after lung transplantation. We did not observe any rehabilitation-related complications during follow-up. The final level of physical function was G1 in six patients, G3 in two patients, and G4 in 14 patients. Fourteen of the 22 patients were able to walk with or without assistance, and 13 of them maintained G4 until discharge; the eight remaining patients never achieved G4.
Conclusions Our results suggest the feasibility of early pulmonary rehabilitation initiated in the ICU within a few days after lung transplantation.
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Citations
Citations to this article as recorded by
- Post-operative, inpatient rehabilitation after lung transplant evaluation (PIRATE): A feasibility randomized controlled trial
Benjamin J Tarrant, Elizabeth Quinn, Rebecca Robinson, Megan Poulsen, Louise Fuller, Greg Snell, Bruce R Thompson, Brenda M Button, Anne E Holland Physiotherapy Theory and Practice.2023; 39(7): 1406. CrossRef - Early Gait Function After Lung Transplantation in Patients With and Without Pretransplant Extracorporeal Membrane Oxygenation Support
Junghwa Do, Hyojin Lim, Kyung Cheon Seo, Suyoung Park, HyeRin Joo, Junghoon Lee, Eunjae Ko, Jaehwal Lim, Ho Cheol Kim, Dongkyu Oh, Sang-Bum Hong, Won Kim Transplantation Proceedings.2023; 55(3): 616. CrossRef
- Pulmonary/Cardiology
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Perioperative Risk Factors associated with Immediate Postoperative Extracorporeal Membrane Oxygenation in Lung Transplants
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Ha Yeon Kim, Sungwon Na, Hyo Chae Paik, Jonglin Ha, Jeongmin Kim
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Korean J Crit Care Med. 2015;30(4):286-294. Published online November 30, 2015
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DOI: https://doi.org/10.4266/kjccm.2015.30.4.286
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5,317
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Abstract
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- Background
Extracorporeal membrane oxygenation (ECMO) is administered for a few days after lung transplantation (LTx) in recipients who are expected to have early graft dysfunction. Despite its life-saving potential, immediate postoperative ECMO has life-threatening complications such as postoperative bleeding. We investigated the risk factors related to the use of immediate postoperative ECMO.
Methods We retrospectively reviewed the records of 60 LTx patients who were at our institution from October 2012 to May 2015. Perioperative variables associated with postoperative ECMO were compared between the two groups.
Results There were 26 patients who received postoperative ECMO (ECMO group) and 34 patients who did not (control group). Multivariate regression analysis revealed preoperative ECMO (odds ratio [OR] 12.55, 95% confidence intervals [CI] 1.34 – 117.24, p = 0.027) and lower peripheral pulse oxymetry saturation (SpO2) at the end of surgery (OR 0.71, 95% CI 0.54 – 0.95, p = 0.019) were independent risk factors for postoperative ECMO in LTx patients. The incidences of complications, such as re-operation, tracheostomy, renal failure and postoperative atrial fibrillation, were higher in the ECMO group. There was no difference in the duration of postoperative intensive care unit stay or postoperative 30-day mortality between the two groups.
Conclusions The preoperative ECMO and lower SpO2 at the end of surgery were associated with postoperative ECMO. Further, postoperative adverse events were higher in the ECMO group compared with the control group. This study suggests that determination of postoperative ECMO requires careful consideration because of the risks of postoperative ECMO in LTx patients.
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Citations
Citations to this article as recorded by
- The Future of Research on Extracorporeal Membrane Oxygenation (ECMO)
Ji Young Lee Korean Journal of Critical Care Medicine.2016; 31(2): 73. CrossRef
- Hematology/Pulmonary
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Hemophagocytic Lymphohistiocytosis after Lung Transplantation
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Ah Young Leem, Sung Woo Moon, Song Yee Kim, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Hyo Chae Paik, June Won Cheong, Kyung Soo Chung
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Korean J Crit Care Med. 2015;30(1):38-41. Published online February 28, 2015
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DOI: https://doi.org/10.4266/kjccm.2015.30.1.38
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Abstract
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- Hemophagocytic lymphohistiocytosis (HLH) is a rare but fatal complication after solid organ transplantation. Acquired forms of HLH are described in association with severe sepsis, autoimmune disorders, malignancy, immune-compromised states, infections, and solid organ transplantation. We experienced a case of hemophagocytic lymphohistiocytosis after bilateral lung transplantation. Leukopenia, thrombocytopenia, and hyperbilirubinemia were noted and became aggravated 50 days after transplantation. Diagnosis of HLH was based on clinical and laboratory findings of splenomegaly, cytopenia, elevated ferritin, elevated interleukin-2 receptor, and hemophagocytosis in bone marrow. Other features such as elevated bilirubin, lactate dehydrogenase, and D-dimer which can be present in HLH were also noted. The patient was immediately treated with etoposide and dexamethasone. Despite aggressive therapy, the patient deteriorated and died. Awareness of the diagnostic criteria of HLH after lung transplantation is important for clinicians.
- Cardiology/Pulmonary
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One Hundred Seven Days of ECMO as a Bridge to Lung Transplantation: The Longest Duration Among Elderly Patients
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Eun Jung Kim, Hyo Chae Paik, Moo Suk Park, Myung Hwa Kim, Shin Ok Koh, You Jin Lee, Sungwon Na
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Korean J Crit Care Med. 2014;29(1):48-51. Published online February 28, 2014
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DOI: https://doi.org/10.4266/kjccm.2014.29.1.48
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4,489
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Abstract
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- Extracorporeal membrane oxygenation (ECMO) is a means for supporting adequate gas exchange in patients with severe respiratory failure and is the only therapeutic option for ventilation-refractory patients awaiting lung transplantation. Moreover, defining the patients likely to benefit from ECMO as a bridge to transplantation has recently become a point of interest. Here, we report a case of prolonged ECMO support to a patient awaiting lung transplantation. A 66-year-old woman was diagnosed with acute interstitial pneumonia and was placed on veno-venous (VV) ECMO due to unsatisfactory gas exchange despite maximal ventilator care. She underwent bilateral lung transplantation after 99 days of ECMO and was successfully weaned from it on the 107th ECMO day. This is the longest period of ECMO support to be reported among elderly patients.
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Citations
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- Long-Term Venovenous Connection for Extracorporeal Carbon Dioxide Removal (ECCO2R)–Numerical Investigation of the Connection to the Common Iliac Veins
N. B. Steuer, K. Hugenroth, T. Beck, J. Spillner, R. Kopp, S. Reinartz, T. Schmitz-Rode, U. Steinseifer, G. Wagner, J. Arens Cardiovascular Engineering and Technology.2020; 11(4): 362. CrossRef - One hundred forty six days on extracorporeal membrane oxygenation (ECMO): Our longest ECMO run
Ahmad Said Abdalmohsen Ali, Mohamed Yosri, Mohamed Abouelwafa, Mahmoud Saad, Kareem Zaki, Shady Mashhour, Husam Salah, Tarek Mohsen, Amaany Abozeid, Mohamed Khaled, Akram Abdelbary, Alia Abdelfattah The Egyptian Journal of Critical Care Medicine.2018; 6(3): 113. CrossRef - Recovery from Acute Respiratory Distress Syndrome with Long-Run Extracorporeal Membrane Oxygenation
Jin Jeon, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Sang-Bum Hong Korean Journal of Critical Care Medicine.2014; 29(3): 212. CrossRef
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