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Bonnemain J, Auberson D, Rutz T, Yerly P, Aubert JD, Roumy A, Pantet O, Rusca M, Liaudet L, Piquilloud L. Simple equations to predict the effects of veno-venous ECMO in decompensated Eisenmenger syndrome. ESC Heart Fail 2021; 8:1637-1642. [PMID: 33630406 PMCID: PMC8006687 DOI: 10.1002/ehf2.13253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/15/2021] [Accepted: 01/26/2021] [Indexed: 12/25/2022] Open
Abstract
Adult patients with uncorrected congenital heart diseases and chronic intracardiac shunt may develop Eisenmenger syndrome (ES) due to progressive increase of pulmonary vascular resistance, with significant morbidity and mortality. Acute decompensation of ES in conditions promoting a further increase of pulmonary vascular resistance, such as pulmonary embolism or pneumonia, can precipitate major arterial hypoxia and death. In such conditions, increasing systemic oxygenation with veno‐venous extracorporeal membrane oxygenation (VV‐ECMO) could be life‐saving, serving as a bridge to treat a potential reversible cause for the decompensation, or to urgent lung transplantation. Anticipating the effects of VV‐ECMO in this setting could ease the clinical decision to initiate such therapeutic strategy. Here, we present a series of equations to accurately predict the effects of VV‐ECMO on arterial oxygenation in ES and illustrate this point by a case of ES decompensation with refractory hypoxaemia consecutive to an acute respiratory failure due to viral pneumonia.
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Affiliation(s)
- Jean Bonnemain
- The Service of Adult Intensive Care Medicine, University Hospital and Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 46, Lausanne, CH-1011, Switzerland
| | - Denise Auberson
- The Service of Cardiology, University Hospital and Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 46, Lausanne, CH-1011, Switzerland
| | - Tobias Rutz
- The Service of Cardiology, University Hospital and Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 46, Lausanne, CH-1011, Switzerland
| | - Patrick Yerly
- The Service of Cardiology, University Hospital and Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 46, Lausanne, CH-1011, Switzerland
| | - John-David Aubert
- The Service of Pneumology, University Hospital and Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 46, Lausanne, CH-1011, Switzerland
| | - Aurélien Roumy
- The Service of Cardiac Surgery, University Hospital and Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 46, Lausanne, CH-1011, Switzerland
| | - Olivier Pantet
- The Service of Adult Intensive Care Medicine, University Hospital and Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 46, Lausanne, CH-1011, Switzerland
| | - Marco Rusca
- The Service of Adult Intensive Care Medicine, University Hospital and Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 46, Lausanne, CH-1011, Switzerland
| | - Lucas Liaudet
- The Service of Adult Intensive Care Medicine, University Hospital and Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 46, Lausanne, CH-1011, Switzerland
| | - Lise Piquilloud
- The Service of Adult Intensive Care Medicine, University Hospital and Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 46, Lausanne, CH-1011, Switzerland
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