Pneumonectomy following penetrating trauma with ECMO as postoperative support: case report – (Lung trauma and ECMO)

TL;DR

This case report describes a patient with a severe chest injury who required a pneumonectomy and ECMO support for recovery.

Contribution

The report highlights the use of ECMO as effective postoperative support in a complex trauma case requiring pneumonectomy.

Findings

Pneumonectomy was necessary to control active bleeding from a penetrating thoracic injury.

ECMO support was crucial in managing right ventricular dysfunction and ARDS post-surgery.

A multidisciplinary approach improved outcomes in this high-risk trauma patient.

Abstract

Penetrating thoracic injuries have a significant risk of morbi-mortality. Despite the advancements in damage control methods, a subset of patients with severe pulmonary vascular lesions and bronchial injuries persists. In some of these cases, post-traumatic pneumonectomy is required, and perioperative extracorporeal membrane oxygenation (ECMO) support may be required due to right ventricular failure and respiratory failure.

A male was brought to the emergency department (ED) with a penetrating thoracic injury, presenting with massive right hemothorax and active bleeding that required ligation of the right pulmonary hilum to control the bleeding. Subsequently, he developed right ventricular dysfunction and ARDS, necessitating a dynamic hybrid ECMO configuration to support his condition and facilitate recovery.

Penetrating thoracic injuries with severe pulmonary vascular lesions may need pneumonectomy to control bleeding. ECMO support reduces the associated mortality by decreasing the complications rate. A multidisciplinary team is essential to achieve good outcomes in severe compromised patients.

Figures