Successful Management of a Patient with Refractory Ventricular Fibrillation (VF) due to Acute Myocardial Infarction (AMI) and Lung Injury by Transition from Percutaneous Cardiopulmonary Support (PCPS) to Veno-Venous Extracorporeal Membrane Oxygenation (ECMO)

• Published in: Internal Medicine Vol. 55; no. 14; pp. 1877 - 1879
• Main Authors: Sato, Atsushi, Isoda, Kikuo, Gatate, Yodo, Akita, Koji, Daida, Hiroyuki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2016
• Subjects: acute myocardial infarction; Aged; cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - adverse effects; Cardiopulmonary Resuscitation - methods; Echocardiography; ECMO; Extracorporeal Membrane Oxygenation; Humans; lung injury; Lung Injury - complications; Male; Myocardial Infarction - complications; PCPS; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - methods; Ventricular Fibrillation - etiology; Ventricular Fibrillation - therapy
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.55.6190

A 69-year-old man was admitted to our hospital with cardiopulmonary arrest. Percutaneous cardio-pulmonary support (PCPS) using the right femoral artery and vein was initiated, because ventricular fibrillation continued. Although we succeeded in defibrillation after percutaneous coronary intervention (PCI), a chest radiograph indicated a pneumothorax in the right lung and a pulmonic contusion in the left lung caused by cardiopulmonary resuscitation. Two days after PCI, partial pressure of arterial oxygen (PaO2) from the right radial artery suddenly decreased, and his cardiac function showed improvement on an echocardiogram. To avoid additional brain damage, we converted the treatment to veno-venous extracorporeal membrane oxygenation by changing the blood returning site of PCPS from the right femoral artery to the right jugular vein. Thereafter, the patient's PaO2 level gradually improved.