Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Cardiothoracic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Perfusion. 2021 Sep;36(6):630-633. doi: 10.1177/0267659120987973. Epub 2021 Jan 9.
Superior vena cava (SVC) syndrome is typically associated with malignant tumors obstructing the SVC, but as many as 40% of cases have other etiologies. SVC obstruction was previously described during veno-venous extracorporeal membrane oxygenation therapy (VV ECMO) in children. In this report, we describe a woman with adult respiratory distress syndrome resulting from infection with coronavirus-19 who developed SVC syndrome during VV ECMO. A dual-lumen ECMO cannula was inserted in the right internal jugular vein, but insufficient ECMO circuit flow, upper body edema, and signs of hypovolemic shock were observed. This clinical picture resolved when the right internal jugular vein was decannulated in favor of bilateral femoral venous cannulae. Our report demonstrates that timely recognition of clinical signs and symptoms led to the appropriate diagnosis of an uncommon ECMO complication.
上腔静脉（SVC）综合征通常与恶性肿瘤阻塞 SVC 有关，但多达 40%的病例有其他病因。以前曾在儿童的静脉-静脉体外膜氧合治疗（VV ECMO）期间描述过 SVC 阻塞。在本报告中，我们描述了一位因感染冠状病毒-19而导致成人呼吸窘迫综合征的女性，在 VV ECMO 期间发生了 SVC 综合征。一根双腔 ECMO 插管被插入右侧颈内静脉，但观察到 ECMO 回路流量不足、上半身水肿和低血容量性休克的迹象。当右侧颈内静脉被拔管，改用双侧股静脉插管时，这种临床情况得到了缓解。我们的报告表明，及时识别临床症状和体征有助于对不常见的 ECMO 并发症做出正确诊断。
