Management experience of veno-arteriovenous ECMO with circuit conversion from venovenous ECMO for right heart failure: a case report

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  • Suzuki Tsuyoshi
    Emergency and Critical Care Center, Fukushima Medical University Hospital, Fukushima Medical University school of Medicine Department of Emergency and Critical Care Medicine, Fukushima Medical University school of Medicine
  • Misawa Tomotaka
    Emergency and Critical Care Center, Fukushima Medical University Hospital, Fukushima Medical University school of Medicine Department of Emergency and Critical Care Medicine, Fukushima Medical University school of Medicine
  • Tsukada Yasuhiko
    Emergency and Critical Care Center, Fukushima Medical University Hospital, Fukushima Medical University school of Medicine Department of Emergency and Critical Care Medicine, Fukushima Medical University school of Medicine
  • Onodera Makoto
    Emergency and Critical Care Center, Fukushima Medical University Hospital, Fukushima Medical University school of Medicine Department of Regional Emergency Medicine, Fukushima Medical University school of Medicine
  • Iseki Ken
    Emergency and Critical Care Center, Fukushima Medical University Hospital, Fukushima Medical University school of Medicine Department of Emergency and Critical Care Medicine, Fukushima Medical University school of Medicine

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  • VV-ECMO管理中に生じた右心不全に対してV-AV ECMOへ回路変更し救命した1例

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<p>We present the case of a 43-year-old man who developed severe pneumonia secondary to influenza virus infection. Following respiratory failure, the patient was placed on mechanical ventilation and initiated on venovenous extracorporeal membrane oxygenation（VV-ECMO） support. However, on the 10th day of hospitalization, he deteriorated into shock. Transthoracic echocardiography revealed significant right ventricular dilatation with compression of the left ventricular wall, leading to a diagnosis of right ventricular failure-induced shock. Despite attempts with inotropic drug therapy, the patient remained in shock, prompting a decision to convert the circuit to veno-arteriovenous ECMO (V-AV ECMO). Following the conversion, a notable improvement was observed in the right heart failure and shock, and the patient was successfully weaned from V-AV ECMO on the 15th day. In cases where right heart failure and shock complicate VV-ECMO management, converting circuits to V-AV ECMO may be useful, particularly in addressing concerns related to differential hypoxemia.</p>

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