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Femoral Venoarterial Extracorporeal Membrane Oxygenation for Severe Reimplantation Response After Lung Transplantation*

Dirk Vlasselaers, MD; Geert M. Verleden, PhD; Bart Meyns, PhD; Dirk Van Raemdonck, MD, PhD, FCCP; Maurits Demedts, MD, PhD, FCCP; Antoon Lerut, PhD; Peter Lauwers, MD
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*From the Departments of Intensive Care Medicine (Drs. Vlasselaers and Lauwers), Respiratory Medicine (Drs. Verleden and Demedts), Cardiac Surgery (Dr. Meyns), and Thoracic Surgery (Drs. Van Raemdonck and Lerut), University Hospital Gasthuisberg, Leuven, Belgium.

Correspondence to: Geert M. Verleden, PhD, Department of Respiratory Medicine, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium; e-mail: Geert.Verleden@uz.kuleuven.ac.be



Chest. 2000;118(2):559-561. doi:10.1378/chest.118.2.559
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Severe pulmonary reimplantation response after lung transplantation is not very common, although the mortality can be high. We present a patient who developed an extremely severe reperfusion injury after bilateral lung transplantation. Because of severe hypoxia and hemodynamic instability, despite aggressive ventilator settings, venoarterial extracorporeal membrane oxygenation (ECMO) was instituted using the femoral approach at the bedside. During ECMO, the patient developed a thoracic wall hematoma that was treated with transfusion alone. After 50 h of ECMO, his chest radiograph had dramatically improved, his oxygen need had been reduced to 50%, and he was successfully weaned from ECMO. Two years later, he is doing extremely well. Therefore, institution of ECMO using the femoral approach can be performed safely at the bedside in the ICU, and can be lifesaving in the context of a very severe reimplantation response after lung transplantation. (CHEST 2000; 118:559–561)


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