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KMID : 0604020150300020109
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Korean Journal of Critical Care Medicine
2015 Volume.30 No. 2 p.109 ~ p.114
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Early Extracorporeal Membrane Oxygenation for Massive Aspiration during Anesthesia Induction
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Kim Na-Mo
Kim Kwan-Hyung
Kim Jeong-Min
Choi Su-Youn
Na Sung-Won
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Abstract
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Although the incidence is not high in the general surgical population, pulmonary aspiration of gastric contents can result in seriouslong-term morbidity and mortality. We report a case of early use of extracorporeal membrane oxygenation (ECMO) to correct severehypoxemia refractory to conventional mechanical ventilation in a patient with massive aspiration of gastric contents immediately followedby acute lung injury during general anesthesia induction.A 64-year-old woman diagnosed with stomach cancer was scheduled for elective diagnostic laparoscopy. Although there was nosign of gastrointestinal tract obstruction and midnight Nil per Os (NPO) was performed before the operation, pulmonary aspirationoccurred during the induction of anesthesia. Despite the endotracheal intubation with mechanical ventilation, severe hypoxemiawith hypercapnea persisted. Medical team agreed with applying veno-venous (VV) ECMO, and her blood gas analysis results becamestable. ECMO was weaned successfully 9 days after the first aspiration event had occurred. Based on this case, early application of extracorporeallife support can have survival benefits.
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KEYWORD
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acute lung injury, aspiration pneumonia, extracorporeal membrane oxygenation
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