Sugiyama Takuya, Ishida Tokiya, Yokoyama Hideyuki, Kumada Yoshibumi, Shinohara Kazuaki
Department of Emergency and Critical Care Medicine Ohta Nishinouchi Hospital Koriyama Japan.
Acute Med Surg. 2020 Mar 15;7(1):e492. doi: 10.1002/ams2.492. eCollection 2020 Jan-Dec.
Published reports regarding the use of veno-venous extracorporeal membrane oxygenation (V-V ECMO) for massive hemoptysis following a thoracic injury are still scarce.
A 34-year-old man developed massive hemoptysis from the right lung after a 2 m fall and being compressed with an iron pipe weighing 500 kg. He was immediately intubated using a double-lumen tube, and one-lung ventilation was started. Endotracheal hemorrhage was controlled by sealing the right lumen. V-V ECMO was initiated to endure the lethal hypoxemia while waiting for the right lung to heal. He came off of V-V ECMO after 17 days and was discharged on foot on day 46.
The strategy of using V-V ECMO in combination with one-lung ventilation is useful and should be strongly considered to save lethal massive hemoptysis cases following traumatic lung injury.
关于静脉-静脉体外膜肺氧合（V-V ECMO）用于胸部损伤后大量咯血的已发表报告仍然很少。
一名34岁男性在从2米高处坠落并被一根500公斤重的铁管挤压后，右侧肺出现大量咯血。他立即使用双腔管插管，并开始进行单肺通气。通过封闭右腔控制气管内出血。在等待右肺愈合的同时，启动V-V ECMO以耐受致命性低氧血症。17天后他脱离V-V ECMO，并于第46天步行出院。
V-V ECMO联合单肺通气的策略是有用的，对于挽救创伤性肺损伤后致命性大量咯血病例应予以强烈考虑。
