Successful Use of Extracorporeal Membrane Oxygenation for Respiratory Failure After Cranial Surgery

Nathaniel Mohney, Jacques Morcos, Amedeo Merenda

Research output: Contribution to journalArticle

Abstract

Background: The use of extracorporeal membrane oxygenation (ECMO) for cardiopulmonary support is indicated for refractory respiratory failure but carries a high morbidity and mortality in the neurosurgical setting due to associated risks of intracranial hemorrhage. Case Description: We describe the case of a 62-year-old man who underwent craniotomy for resection of an esthesioneuroblastoma involving the anterior skull base and extending intracranially, through the cribriform plate into the right epidural space. He developed refractory hypoxemic and hypercapnic respiratory failure and circulatory shock in the immediate postoperative period. Our patient was successfully treated with ECMO after other aggressive resuscitative measures proved unsuccessful for several hours. The patient was managed with ECMO for 6 days, after which he was successfully weaned without developing any neurologic complications. Conclusion: Our case report is significant because it describes the safe use of ECMO in a controversial setting because our patient had recently undergone craniotomy. We conclude that in dire circumstances the use of ECMO is appropriate and may be safe even in the setting of recent craniotomy.

Original languageEnglish (US)
Pages (from-to)426-429
Number of pages4
JournalWorld Neurosurgery
Volume120
DOIs
StatePublished - Dec 1 2018

Keywords

  • Acute respiratory distress syndrome
  • Cranial surgery
  • Extracorporeal membrane oxygenation

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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