Cryotherapy: A Safe Approach to Pulmonary Hemorrhage During VV-ECMO. (February 2022)

• Record Type: Journal Article
• Authors: Green, Adam; Puri, Nitin; Kouch, Michael; Wolfe, Yanika; Balakrishnan, Archana; Abramian, Osheen; Boujaoude, Ziad; Abouzgheib, Wissam
• Is Part Of: Journal of investigative medicine high impact case reports. Volume 10(2022)
• Publication Date: 2022-02
• Subjects: acute respiratory distress syndrome -- ARDS -- extracorporeal life support -- extracorporeal membrane oxygenation -- hemoptysis -- pulmonary hemorrhage -- cryotherapy -- bronchoscopy; Internal medicine -- Periodicals; Medical care -- Periodicals; 616.005
• DOI: 10.1177/23247096221074590
• Languages: English
• ISSNs: 2324-7096

Abstract

The number of hospitals with veno-venous extracorporeal membrane oxygenation (VV-ECMO) capabilities is expanding. To support an ECMO program, centers must be equipped to handle associated complications such as pulmonary hemorrhage. We describe a case series of 4 patients with life-threatening pulmonary bleeding and central airway obstruction. A therapeutic approach of anticoagulation cessation coupled with cryoextraction via flexible bronchoscopy led to successful restoration of airway patency without any adverse events. A low threshold to stop anticoagulation with a strong consideration of bronchoscopy with cryotherapy for pulmonary toilet should be done in patients with pulmonary hemorrhage during VV-ECMO.