Abstract Since April 1973 we have treated nine patients with extracorporeal membrane oxygenation (ECMO), utilizing the spiral coil membrane lung. One patient is a long-term survivor. All patients except one showed substantial improvement in peripheral arterial oxygen tension. Four adults and two neonates were treated for critical hypoxia. Two patients were treated for cardiac failure but failed to show improved myocardial function. Complications involving perfusion circuitry, cannulation, chronic systemic heparinization, thrombocytopenia, and renal failure have been managed with minimal difficulty. However, irreversible pulmonary, neurologic, hepatic, or gastrointestinal damage due to hypoxia present before the institution of ECMO was associated with lethal complications. The ECMO has supplied adequate oxygenation to this group of nine critically hypoxic patients. Institution of ECMO at an earlier date in patients with critical hypoxia would provide a higher likelihood of survival. References 1. Kolobow T, Zapol WM, Sigman RL, et al: Partial cardiopulmonary bypass lasting up to seven days in alert lambs with membrane lung blood oxygenation . J Thorac Cardiovasc Surg 60:781-795, 1970. 2. Hill JD, de Leval MR, Fallat RJ, et al: Acute respiratory insufficiency: Treatment with prolonged extracorporeal oxygenation . J Thorac Cardiovasc Surg 64:1555-1562, 1972. 3. Pierce EC II, Thebaut AL, Kent BB, et al: Techniques of extended perfusion using a membrane lung . Ann Thorac Surg 12:451-470, 1971.Crossref 4. Rea WJ, Eberle JW, Ecker RR, et al: Long-term membrane oxygenation in respiratory failure . Ann Thorac Surg 15:170-178, 1973.Crossref 5. Lefrak EA, Stevens PM, Noon GP, et al: Current status of prolonged extracorporeal membrane oxygenation for acute respiratory failure . Chest 63:773-782, 1973.Crossref 6. White JJ, Leenders E, Andrews HG, et al: Studies of a membrane oxygenator for prolonged respiratory support . J Pediatr Surg 5:610-619, 1970.Crossref 7. Ward BD, Hood AG: Comparative performance of clinical membrane lungs . J Thorac Cardiovasc Surg 68:830-836, 1974.
Archives of Surgery – American Medical Association
Published: Aug 1, 1975