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A single center experience of using ECMO in anesthesia for lung transplantation

Objective: To explore the use of extracorporeal membrane oxygenation(ECMO) during lung transplantation anesthesia, and summarize the experience. Methods: From December 2016 to December 2020, the clinical data of 19 patients with lung transplantation using ECMO during anesthesia in Renmin Hospital of Wuhan University were retrospectively analyzed. Results: Among the 19 patients, the main diagnosis were chronic obstructive pulmonary diseases in 5 cases, idiopathic pulmonary fibrosis in 6 cases, bronchiectasis in 2 cases, pneumoconiosis in 4 cases, Kartagener syndrome in 1 case, and COVID-19 with advanced pulmonary fibrosis in 1 case. A total of 9 patients used ECMO to complete the operation. ECMO was used in 2 cases before anesthesia and 7 cases received ECMO treatment after anesthesia. Among them, 5 cases were veno-venous (V-V) ECMO and 4 cases were veno-arterial (V-A) ECMO. During operation, V-A ECMO was changed to veno-artery-vein (V-A-V) ECMO in 1 case, another case used V-V plus V-A ECMO. After operation, 4 cases removed ECMO successfully and returned to the intensive care unit, and 5 cases took ECMO back to the intensive care unit. Among them, 4 cases removed ECMO successfully and 1 case failed due to multiple infections. Among the 10 patients who did not receive ECMO, 1 patient had cardiac arrest during the operation. Conclusion: ECMO is an important auxiliary tool in lung transplantation. Accurate evaluation of patients' cardiopulmonary function and use of ECMO, according to their oxygenation and circulatory status, can provide effective support for lung transplantation anesthesia. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.