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3 "Pil-Je Kang"
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Cardiology
Clinical implications of pleural effusion following left ventricular assist device implantation
So-Min Lim, Ah-Ram Kim, Junho Hyun, Sang-Eun Lee, Pil-Je Kang, Sung-Ho Jung, Min-Seok Kim
Acute Crit Care. 2024;39(1):169-178.   Published online January 17, 2024
DOI: https://doi.org/10.4266/acc.2023.01102
  • 742 View
  • 58 Download
  • 1 Crossref
AbstractAbstract PDF
Background
Studies on the association between pleural effusion (PE) and left ventricular assist devices (LVADs) are limited. This study aimed to examine the characteristics and the clinical impact of PE following LVAD implantation. Methods: This study is a prospective analysis of patients who underwent LVAD implantation from June 2015 to December 2022. We investigated the prognostic impact of therapeutic drainage (TD) on clinical outcomes. We also compared the characteristics and clinical outcomes between early and late PE and examined the factors related to the development of late PE. Results: A total of 71 patients was analyzed. The TD group (n=45) had a longer ward stay (days; median [interquartile range]: 31.0 [23.0–46.0] vs. 21.0 [16.0–34.0], P=0.006) and total hospital stay (47.0 [36.0–82.0] vs. 31.0 [22.0–48.0], P=0.002) compared to the no TD group (n=26). Early PE was mostly exudate, left-sided, and neutrophil-dominant even though predominance of lymphocytes was the most common finding in late PE. Patients with late PE had a higher rate of reintubation within 14 days (31.8% vs. 4.1%, P=0.004) and longer hospital stays than those without late PE (67.0 [43.0–104.0] vs. 36.0 [28.0–48.0], P<0.001). Subgroup analysis indicated that female sex, low body mass index, cardiac resynchronization therapy, and hypoalbuminemia were associated with late PE. Conclusions: Compared to patients not undergoing TD, those undergoing TD had a longer hospital stay but not a higher 90-day mortality. Patients with late PE had poor clinical outcomes. Therefore, the correction of risk factors, like hypoalbuminemia, may be required.

Citations

Citations to this article as recorded by  
  • Nuances of pleural effusion after left ventricular assist devices implantation: insights from therapeutic drainage and preoperative predictors
    Huijin Lee, Jeehoon Kang
    Acute and Critical Care.2024; 39(1): 192.     CrossRef
Pulmonary
Use of extracorporeal membrane oxygenation in patients with acute high-risk pulmonary embolism: a case series with literature review
You Na Oh, Dong Kyu Oh, Younsuck Koh, Chae-Man Lim, Jin-Won Huh, Jae Seung Lee, Sung-Ho Jung, Pil-Je Kang, Sang-Bum Hong
Acute Crit Care. 2019;34(2):148-154.   Published online May 31, 2019
DOI: https://doi.org/10.4266/acc.2019.00500
  • 7,396 View
  • 221 Download
  • 21 Web of Science
  • 22 Crossref
AbstractAbstract PDF
Background
Although extracorporeal membrane oxygenation (ECMO) has been used for the treatment of acute high-risk pulmonary embolism (PE), there are limited reports which focus on this approach. Herein, we described our experience with ECMO in patients with acute high-risk PE.
Methods
We retrospectively reviewed medical records of patients diagnosed with acute highrisk PE and treated with ECMO between January 2014 and December 2018.
Results
Among 16 patients included, median age was 51 years (interquartile range [IQR], 38 to 71 years) and six (37.5%) were male. Cardiac arrest was occurred in 12 (75.0%) including two cases of out-of-hospital arrest. All patients underwent veno-arterial ECMO and median ECMO duration was 1.5 days (IQR, 0.0 to 4.5 days). Systemic thrombolysis and surgical embolectomy were performed in seven (43.8%) and nine (56.3%) patients, respectively including three patients (18.8%) received both treatments. Overall 30-day mortality rate was 43.8% (95% confidence interval, 23.1% to 66.8%) and 30-day mortality rates according to the treatment groups were ECMO alone (33.3%, n=3), ECMO with thrombolysis (50.0%, n=4) and ECMO with embolectomy (44.4%, n=9).
Conclusions
Despite the vigorous treatment efforts, patients with acute high-risk PE were related to substantial morbidity and mortality. We report our experience of ECMO as rescue therapy for refractory shock or cardiac arrest in patients with PE.

Citations

Citations to this article as recorded by  
  • Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest: an overview of current practice and evidence
    Samir Ali, Christiaan L. Meuwese, Xavier J. R. Moors, Dirk W. Donker, Anina F. van de Koolwijk, Marcel C. G. van de Poll, Diederik Gommers, Dinis Dos Reis Miranda
    Netherlands Heart Journal.2024; 32(4): 148.     CrossRef
  • Integration of Extracorporeal Membrane Oxygenation into the Management of High-Risk Pulmonary Embolism: An Overview of Current Evidence
    Romain Chopard, Raquel Morillo, Nicolas Meneveau, David Jiménez
    Hämostaseologie.2024;[Epub]     CrossRef
  • Evidence-Based Management of Massive and Submassive Pulmonary Embolism
    Sara Al-Juboori, Tareq Alzaher, Hashem Al Omari, Sufyan Al Gammaz, Mazen Al-Qadi
    JAP Academy Journal.2024;[Epub]     CrossRef
  • Mechanical Support in High-Risk Pulmonary Embolism: Review Article
    Amer N. Kadri, Razan Alrawashdeh, Mohamad K. Soufi, Adam J. Elder, Zachary Elder, Tamam Mohamad, Eric Gnall, Mahir Elder
    Journal of Clinical Medicine.2024; 13(9): 2468.     CrossRef
  • Extracorporeal membrane oxygenation for large pulmonary emboli
    Timothy J. George, Jenelle Sheasby, Rahul Sawhney, J. Michael DiMaio, Aasim Afzal, Dennis Gable, Sameh Sayfo
    Baylor University Medical Center Proceedings.2023; 36(3): 314.     CrossRef
  • Surgical Management and Mechanical Circulatory Support in High-Risk Pulmonary Embolisms: Historical Context, Current Status, and Future Directions: A Scientific Statement From the American Heart Association
    Joshua B. Goldberg, Jay Giri, Taisei Kobayashi, Marc Ruel, Alexander J.C. Mittnacht, Belinda Rivera-Lebron, Abe DeAnda, John M. Moriarty, Thomas E. MacGillivray
    Circulation.2023;[Epub]     CrossRef
  • Life-threatening pulmonary embolism: overview and management
    Nizar Osmani, Jonathan Marinaro, Sundeep Guliani
    International Anesthesiology Clinics.2023; 61(4): 35.     CrossRef
  • Extracorporeal Membrane Oxygenation for Pulmonary Embolism: A Systematic Review and Meta-Analysis
    Jonathan Jia En Boey, Ujwal Dhundi, Ryan Ruiyang Ling, John Keong Chiew, Nicole Chui-Jiet Fong, Ying Chen, Lukas Hobohm, Priya Nair, Roberto Lorusso, Graeme MacLaren, Kollengode Ramanathan
    Journal of Clinical Medicine.2023; 13(1): 64.     CrossRef
  • Pulmonary ECMO-ism: Let’s add PEA to ECPR indications
    Zachary Shinar, Alice Hutin
    Resuscitation.2022; 170: 293.     CrossRef
  • Combined use of extracorporeal membrane oxygenation with interventional surgery for acute pancreatitis with pulmonary embolism: A case report
    Ling-Ling Yan, Xiu-Xiu Jin, Xiao-Dan Yan, Jin-Bang Peng, Zhuo-Ya Li, Bi-Li He
    World Journal of Clinical Cases.2022; 10(12): 3899.     CrossRef
  • Pulmonary Embolism Complicated With Cardiopulmonary Arrest Treated With Combination of Thrombolytics and Aspiration Thrombectomy
    Taylor C. Remillard, Zain Kassam, Maks Coven, Aditya Mangla, Zoran Lasic
    JACC: Case Reports.2022; 4(10): 576.     CrossRef
  • Anesthetic management for intraoperative acute pulmonary embolism during inferior vena cava tumor thrombus surgery: A case report
    Pei-Yu Hsu, En-Bo Wu
    World Journal of Clinical Cases.2022; 10(15): 5111.     CrossRef
  • Percutaneous mechanical thrombectomy and extracorporeal membranous oxygenation: A case series
    Haytham Mously, Jamal Hajjari, Tarek Chami, Tarek Hammad, Robert Schilz, Teresa Carman, Yakov Elgudin, Yasir Abu‐Omar, Marc P. Pelletier, Mehdi H. Shishehbor, Jun Li
    Catheterization and Cardiovascular Interventions.2022; 100(2): 274.     CrossRef
  • Clinical Experiences of High-Risk Pulmonary Thromboembolism Receiving Extracorporeal Membrane Oxygenation in Single Institution
    Joonyong Jang, So-My Koo, Ki-Up Kim, Yang-Ki Kim, Soo-taek Uh, Gae-Eil Jang, Wonho Chang, Bo Young Lee
    Tuberculosis and Respiratory Diseases.2022; 85(3): 249.     CrossRef
  • Management of High-Risk Pulmonary Embolism: What Is the Place of Extracorporeal Membrane Oxygenation?
    Benjamin Assouline, Marie Assouline-Reinmann, Raphaël Giraud, David Levy, Ouriel Saura, Karim Bendjelid, Alain Combes, Matthieu Schmidt
    Journal of Clinical Medicine.2022; 11(16): 4734.     CrossRef
  • Optimal reperfusion strategy in acute high-risk pulmonary embolism requiring extracorporeal membrane oxygenation support: a systematic review and meta-analysis
    Romain Chopard, Peter Nielsen, Fabio Ius, Serghei Cebotari, Fiona Ecarnot, Hugo Pilichowski, Matthieu Schmidt, Benedict Kjaergaard, Iago Sousa-Casasnovas, Mehrdad Ghoreishi, Rajeev L. Narayan, Su Nam Lee, Gregory Piazza, Nicolas Meneveau
    European Respiratory Journal.2022; 60(5): 2102977.     CrossRef
  • Use of extracorporeal membrane oxygenation in high‐risk acute pulmonary embolism: A systematic review and meta‐analysis
    Luca Baldetti, Alessandro Beneduce, Lorenzo Cianfanelli, Giulio Falasconi, Luigi Pannone, Francesco Moroni, Angela Venuti, Stefania Sacchi, Mario Gramegna, Vittorio Pazzanese, Francesco Calvo, Guglielmo Gallone, Matteo Pagnesi, Alberto Maria Cappelletti
    Artificial Organs.2021; 45(6): 569.     CrossRef
  • Institutional Experience With Venoarterial Extracorporeal Membrane Oxygenation for Massive Pulmonary Embolism: A Retrospective Case Series
    Maxwell A. Hockstein, Christina Creel-Bulos, Joshua Appelstein, Craig S. Jabaley, Michael J. Stentz
    Journal of Cardiothoracic and Vascular Anesthesia.2021; 35(9): 2681.     CrossRef
  • Venoarterial Extracorporeal Membrane Oxygenation in Massive Pulmonary Embolism-Related Cardiac Arrest: A Systematic Review*
    John Harwood Scott, Matthew Gordon, Robert Vender, Samantha Pettigrew, Parag Desai, Nathaniel Marchetti, Albert James Mamary, Joseph Panaro, Gary Cohen, Riyaz Bashir, Vladimir Lakhter, Stephanie Roth, Huaqing Zhao, Yoshiya Toyoda, Gerard Criner, Lisa Moor
    Critical Care Medicine.2021; 49(5): 760.     CrossRef
  • Adult Langerhans histiocytosis with rare BRAF mutation complicated by massive pulmonary embolism
    Salma Hassan, Christina Fanola, Amy Beckman, Faqian Li, Andrew C. Nelson, Michael Linden, Joan D. Beckman
    Thrombosis Research.2020; 193: 207.     CrossRef
  • Efficacy and safety of extracorporeal membrane oxygenation for high-risk pulmonary embolism: A systematic review and meta-analysis
    Matteo Pozzi, Augustin Metge, Anthony Martelin, Caroline Giroudon, Justine Lanier Demma, Catherine Koffel, William Fornier, Pascal Chiari, Jean Luc Fellahi, Jean Francois Obadia, Xavier Armoiry
    Vascular Medicine.2020; 25(5): 460.     CrossRef
  • Evidence-Based Minireview: Advanced therapies and extracorporeal membrane oxygenation for the management of high-risk pulmonary embolism
    Radhika Gangaraju, Frederikus A. Klok
    Hematology.2020; 2020(1): 195.     CrossRef
Case Report
Pulmonary
Right ventricular assist device with an oxygenator using extracorporeal membrane oxygenation as a bridge to lung transplantation in a patient with severe respiratory failure and right heart decompensation
Dong Kyu Oh, Tae Sun Shim, Kyung-Wook Jo, Seung-Il Park, Dong Kwan Kim, Sehoon Choi, Geun Dong Lee, Sung-Ho Jung, Pil-Je Kang, Sang-Bum Hong
Acute Crit Care. 2020;35(2):117-121.   Published online April 8, 2019
DOI: https://doi.org/10.4266/acc.2018.00416
  • 9,690 View
  • 280 Download
  • 16 Web of Science
  • 20 Crossref
AbstractAbstract PDF
Right heart decompensation is a fatal complication in patients with respiratory failure, particularly in those transitioned to lung transplantation using veno-venous extracorporeal membrane oxygenation (V-V ECMO). In these patients, veno-arterial (V-A ECMO) or veno-arterialvenous extracorporeal membrane oxygenation (V-AV ECMO) is used to support both cardiac and respiratory function. However, these processes may increase the risk of device-related complications such as bleeding, thromboembolism, and limb ischemia. In the present case, a 64-year-old male patient with idiopathic pulmonary fibrosis developed respiratory failure and commenced treatment with V-V ECMO as a bridge to lung transplantation. Unfortunately, the patient developed right heart decompensation and required both cardiac and respiratory support during treatment with V-V ECMO. Instead of adding arterial cannulation, he was switched to a novel configuration, a right ventricular assist device with an oxygenator (Oxy- RVAD) using ECMO, with drainage cannulation from the femoral vein and return cannulation to the main pulmonary artery. The patient was successfully bridged to lung transplantation without serious complications after 10 days of Oxy-RVAD support. To the best of our knowledge, this is an extreme rare and challenging case of Oxy-RVAD using ECMO in a patient successfully bridged to lung transplantation.

Citations

Citations to this article as recorded by  
  • The Role of Palliative Care in Cardiovascular Disease
    John Arthur McClung, William H. Frishman, Wilbert S. Aronow
    Cardiology in Review.2024;[Epub]     CrossRef
  • Percutaneous Venopulmonary Extracorporeal Membrane Oxygenation as Bridge to Lung Transplantation
    Asad Ali Usman, Audrey Elizabeth Spelde, Wasim Lutfi, Jacob T. Gutsche, William J. Vernick, Omar Toubat, Salim E. Olia, Edward Cantu, Andrew Courtright, Maria M. Crespo, Joshua Diamond, Mauer Biscotti, Christian A. Bermudez
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    Juliette Beaulieu, Christine Vu, Sanjog Kalra, Hamza Ouazani Chahdi, Julie Cousineau, Alexis Matteau, Samer Mansour, E. Marc Jolicoeur, Sabrina Jacques, Bénédicte Nauche, Renata Podbielski, Pasquale Ferraro, Charles Poirier, Brian J. Potter
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  • Percutaneous OxyRVAD in a Patient with Severe Respiratory Failure and Right Heart Failure: A Case Report
    Ga Young Yoo, June Lee, Seok Beom Hong, Do Yeon Kim
    Journal of Chest Surgery.2024; 57(3): 319.     CrossRef
  • Central Venopulmonary Extracorporeal Membrane Oxygenation: Background and Standardized Nomenclature
    J. Michael Brewer, Roberto Lorusso, L. Mikael Broman, Steven A. Conrad, Justyna Swol, Marc O. Maybauer
    ASAIO Journal.2024;[Epub]     CrossRef
  • Early Mobilization for a Patient With a Right Ventricular Assist Device With an Oxygenator
    Sheena MacFarlane, Vanessa Lee, Adrienne H. Simonds, Samantha Alvarez, Samantha Carty, Kevin H. Ewers, Victoria R. Kelly, Parker Linden, Amanda L. Moskal
    Journal of Acute Care Physical Therapy.2023; 14(1): 45.     CrossRef
  • A 35-month-old boy who ingested laundry detergent pods and underwent veno-pulmonary extracorporeal membrane oxygenation support
    Hye-ji Han, Bongjin Lee, Won Jin Jang, Ji Won Lee, Jin Hee Kim, Sungkyu Cho, June Dong Park
    Pediatric Emergency Medicine Journal.2023; 10(4): 175.     CrossRef
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    Jae Guk Lee, Chuiyong Pak, Dong Kyu Oh, Ho Cheol Kim, Pil-Je Kang, Geun Dong Lee, Se Hoon Choi, Sung-Ho Jung, Sang-Bum Hong
    Journal of Cardiothoracic and Vascular Anesthesia.2022; 36(6): 1686.     CrossRef
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    Asad A. Usman, Audrey E. Spelde, Michael Ibrahim, Marisa Cevasco, Christian Bermudez, Emily MacKay, Sameer Khandhar, Wilson Szeto, William Vernick, Jacob Gutsche
    ASAIO Journal.2022; 68(12): 1461.     CrossRef
  • Percutaneous Pulmonary Artery Cannulation to Treat Acute Secondary Right Heart Failure While on Veno-venous Extracorporeal Membrane Oxygenation
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    Clinics in Chest Medicine.2021; 42(1): 155.     CrossRef
  • Successful Lung Transplantation After 213 Days of Extracorporeal Life Support: Role of Oxygenator-Right Ventricular Assist Device
    Jae Kyeom Sim, Kyeongman Jeon, Gee Young Suh, Suryeun Chung, Yang Hyun Cho
    ASAIO Journal.2021; 67(7): e127.     CrossRef
  • Oxy-right Ventricular Assist Device for Bridging of Right Heart Failure to Lung Transplantation
    Sung Kwang Lee, Do Hyung Kim, Woo Hyun Cho, Hye Ju Yeo
    Transplantation.2021; 105(7): 1610.     CrossRef
  • Interventional and Surgical Treatments for Pulmonary Arterial Hypertension
    Tomasz Stącel, Magdalena Latos, Maciej Urlik, Mirosław Nęcki, Remigiusz Antończyk, Tomasz Hrapkowicz, Marcin Kurzyna, Marek Ochman
    Journal of Clinical Medicine.2021; 10(15): 3326.     CrossRef
  • Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: an Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
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  • Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: An Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
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ACC : Acute and Critical Care