Cooper Medical School of Rowan University, Camden, NJ, USA.
J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096221074590. doi: 10.1177/23247096221074590.
The number of hospitals with veno-venous extracorporeal membrane oxygenation (VV-ECMO) capabilities is expanding. To support an ECMO program, centers must be equipped to handle associated complications such as pulmonary hemorrhage. We describe a case series of 4 patients with life-threatening pulmonary bleeding and central airway obstruction. A therapeutic approach of anticoagulation cessation coupled with cryoextraction via flexible bronchoscopy led to successful restoration of airway patency without any adverse events. A low threshold to stop anticoagulation with a strong consideration of bronchoscopy with cryotherapy for pulmonary toilet should be done in patients with pulmonary hemorrhage during VV-ECMO.
具有静脉-静脉体外膜肺氧合（VV-ECMO）能力的医院数量正在增加。为了支持 ECMO 计划，中心必须具备处理相关并发症的能力，如肺出血。我们描述了 4 例有生命危险的肺出血和中央气道阻塞的患者病例系列。停止抗凝治疗加上通过纤维支气管镜进行冷冻提取的治疗方法成功地恢复了气道通畅，没有任何不良事件。在 VV-ECMO 期间发生肺出血的患者，应考虑停止抗凝治疗，并强烈考虑使用冷冻疗法进行支气管镜肺灌洗。
