Table 1.
Case series describing at least 5 patients undergoing thoracic or airway reconstruction procedure on ECMO or ECCO2R.
| Author, Year | Indications for ECMO or ECCO2R | Prevalent Types of Surgery | Number of Patients (Configuration: Cannulation) |
Intraoperative Heparin |
Time on ECMO or ECCO2R | ECMO-Related Complications |
Hospital/30-Day Mortality |
|---|---|---|---|---|---|---|---|
| Wiebe K, 2010 [11] | 6 single lung 4 LLF due to ARDS |
5 tracheal resection or repair 4 lung resection 1 partial decortication |
10 (pumpless ECCO2R: V 19F fem-A 17F fem) | can 500–1000 IU none |
6 intraop. 4 postop. for 6.8 days |
1 retroperitoneal hematoma | 2/10 (20%) in total 0/4 (0%) elective 2/6 (33%) urgent |
| Chang X, 2014 [21] | 7 CTBR | 7 tracheal resection | 7 (VA: V 19F fem-A 17F fem) | can 200 IU/kg ACT 300 s |
10–31 min | none | 0/7 (0%) |
| Redwan B, 2015 [14] | 5 single lung 3 LLF 1 carinal resection |
7 pulmonary resection 2 extended metastasectomy 1 carinal PE |
9 (3 VV: V 25F fem-V 21 IJV; 6 ECCO2R: 24 F DL fem) | 2000–4000 IU none |
129 ± 40 min intraop. only |
not reported | 1/9 (11%) |
| Lang G, 2011 [15] Lang G, 2015 [22] |
8 CTBR 2 LLF |
6 carinal resection 3 sleeve (bi)lobectomy 1 sleeve PE |
10 (VA: 7 central RA-AoA + 3 peripheral fem-fem) | can 3000–5000 IU none |
113 ± 17 min intraop. only |
none | 0/10 (0%) |
| Rinieri P, 2015 [16] | 23 CTBR 5 single lung 5 LLF including trauma 3 ECMO preoperatively |
tracheal/carinal reconstruction, wedge resection to PE, lymphadenectomy |
36 (16 VA: 6 central + 10 peripheral; 20 VV; 5 ECCO2R) | can 50–100 IU/kg ACT 160–200 s |
median 65 min for VA and 78 min for VV ECMO, many postop. | 7 reoperations due to bleeding (6 operation site, 1 cannulation site) | 6/36 (17%) in total 1/27 (4%) elective 5/9 (56%) urgent |
| Kim SH, 2017 [23] | 6 post-intubation or post-tracheostomy stenosis | tracheal/carinal reconstruction | 9 (1 VA: peripheral; 8 VV: 6 fem-fem + 2 fem-IJV) | can 50–100 IU/kg ACT 150–180 s |
7 intra-op. for 1.5–4 h, 2 postop | none | 1/9 (11%) 0/6 elective 1/3 (33%) urgent |
| Akil A, 2020 [13] | 65 emphysema with hypercapnia | 65 LVRS | 65 (ECCO2R: 24F DL fem or 22F DL IJV) | none | all postop., mean 3 days | 1 disseminated intravascular coagulopathy | 90-day mortality 5/65 (8%) |
| Kim CW, 2015 [24] Kim DH, 2021 [25] |
27 LLF (pneumonia etc.) 19 airway disease |
27 lung resection 19 airway surgery 17 others |
63 (21 VA: peripheral fem-fem; 42 VV fem-IJV) | can 50–70 IU/kg none |
mean 4.5 days postop. | not reported | 17/63 (27 %) in total 9/11 (82%) eCPR |
| Koryllos A, 2021 [9] | 8 CTBR 16 left lung and descending aorta or left atrium resection |
sleeve lobectomy or PE, lobectomy or PE with left atrial or aortic resection |
24 (7 VA fem-fem; 9 VV-A fem+IJV-fem; 8 VV: 7 fem-IJV + 1 fem-fem) | APTT-R 1.5 | not reported | 2 reoperations due to bleeding at operation site | 6/24 (25%) mortality of 4 acute cases not reported |
Legend: A—arterial, ACT—activated clotting time, AoA—ascending aorta, APTT—activated partial thromboplastin time, can—dose administered before cannulation, CTBR—complex tracheobronchial reconstructions, DL—double lumen cannula, ECCO2R—extracorporeal CO2 removal, ECMO—extracorporeal membrane oxygenation, eCPR—extracorporeal cardiopulmonary resuscitation, F—French, fem—femoral, IJV—internal jugular vein, LLF—limited lung function, LVRS—lung volume reduction surgery, PE—pneumonectomy, RA—right atrium, V—venous; numbers at the beginning of a line represent the number of patients (if stated).