Heymer Johannes, Bent Daniel, Raepple Daniel
Internal Medicine Intensive Care, Klinikum Stuttgart, Kriegsbergstrasse 60, 70174, Stuttgart, Germany.
J Artif Organs. 2024 Dec 13. doi: 10.1007/s10047-024-01483-7.
This case report details a rare instance of total reversal of the pulmonary circulation (RPC) in a 56-year-old male patient on veno-arterial extracorporeal membrane oxygenation (V-A ECMO) during emergency cardiopulmonary resuscitation (eCPR) following a myocardial infarction and cardiac arrest. Previously unrecognized aortic and mitral valve regurgitations, along with V-A ECMO flow, resulted in severe pulmonary edema. We describe how pulmonary artery cannulation and modifying the ECMO circuit to veno-pulmonary arterial-arterial (VPa-A) ECMO successfully alleviated the severe pulmonary edema but may have caused reversal of the pulmonary circulation (RPC). To our knowledge, this is the first reported case of this phenomenon in a human.
本病例报告详细介绍了一名56岁男性患者在心肌梗死和心脏骤停后进行紧急心肺复苏（eCPR）期间，接受静脉-动脉体外膜肺氧合（V-A ECMO）时发生罕见的肺循环完全逆转（RPC）情况。先前未被识别的主动脉瓣和二尖瓣反流，加上V-A ECMO血流，导致了严重的肺水肿。我们描述了肺动脉插管以及将ECMO回路改为静脉-肺动脉-动脉（VPa-A）ECMO如何成功缓解了严重的肺水肿，但可能导致了肺循环逆转（RPC）。据我们所知，这是人类中首次报道的这种现象的病例。
