Use veno-venous extra corporeal membrane oxygenation in elderly patients with post-cardiotomy hypoxia: the changing paradigm of respiratory support in adult respiratory distress syndrome

J Cardiothorac Surg. 2019 Jan 14;14(1):10. doi: 10.1186/s13019-019-0833-y.

Abstract

Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) support for ARDS treatment after cardiac surgery has progressed remarkably in the last 20 years. However, one of the limitations of a successful recover is age, being a powerful predictor of mortality.

Case presentation: In this case report we discuss a 78-year-old man who underwent aortic valve and aortic root replacement. The postoperative period was complicated by ARDS following aspiration pneumonia treated with VV-ECMO weaned after 6 days. At two-year follow up, the patient made an excellent recover, being the second oldest person to survive VV-ECMO following cardiac surgery in the world.

Conclusion: In the literature there is no consensus regarding a specific age limit and results, in the use of ECMO in the elderly are scarce and inconsistent. We do not think advanced age is a contraindication to the use of ECMO.

Keywords: Acute respiratory distress syndrome (ARDS), cardiac surgery; Veno-venous extracorporeal membrane oxygenation (VV-ECMO).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Cardiac Surgical Procedures / adverse effects*
  • Extracorporeal Membrane Oxygenation / methods*
  • Humans
  • Hypoxia / etiology
  • Hypoxia / therapy*
  • Male
  • Postoperative Complications*
  • Respiratory Distress Syndrome / complications
  • Respiratory Distress Syndrome / therapy*