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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
RESPIRATORY ECMO: BENEFITS BEYOND GAS EXCHANGE
Author
Deepa Gopalan1 and Kamen Valchanov2
Email
kamen.valchanov@nhs.net
keyword
Tuberculosis Respiratory Failure ECMO Extracorporeal Membrane Oxygenation Tamponade Haemothorax Avalon
Abstract
A 32 years old male patient was suffering from a severe form of tuberculosis necessitating respiratory support with peripheral veno-venous ECMO through a dual lumen Avalon Elite cannula inserted through the right internal jugular vein into the SVC and IVC. Left pleural effusion was treated with intercostal drain. Over the following 24 hours the patient became profoundly hypotensive, with reduced ECMO flow, and reduced haemoglobin level. Chest radiograph showed complete white out of both lungs with a left chest drain and a deviated right Avalon Elite ECMO cannula. Multidetector computed tomography demonstrated a large left haemothorax adjacent to the chest drain, causing mediastinal shift to the right. The right ventricle was compressed against the chest wall and there was collapse of both lungs. The compression of the right ventricle against right anterior chest wall explained the clinical presentation of extrapericardial tamponade. We stipulate that the presence of the long large bore relatively rigid Avalon Elite ECMO cannula precluded the mediastinum from further displacement and imminent cardiac arrest. The haemothorax was surgically evacuated and after two months ECMO was weaned off.
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