Abstract
The patient in this case report was an 88-year-old male. Acute upper airway obstruction by food led to transient cardiac arrest, and negative pressure pulmonary hemorrhage (NPPH) occurred 1 hour after the foreign body obstruction. Using venovenous extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome resulting from NPPH, his respiratory state was recovered and hemoptysis stopped. NPPH is a life-threatening disease, the rapid recognition of which is required to initiate appropriate therapy. Although active hemorrhage might be a contraindication for ECMO, our experience showed this to be an effective treatment option. Moreover, our experience suggests that the application of ECMO to elderly patients should be considered on a case-by-case basis.
Highlights
Negative pressure pulmonary edema (NPPE) and hemorrhage (NPPH) are uncommon problems resulting from upper airway obstruction [1]
Active hemorrhage might be a contraindication for extracorporeal membrane oxygenation (ECMO), it is considered for life-threatening acute respiratory distress syndrome (ARDS) when the underlying condition is reversible despite optimal ventilatory support [4]
This paper presents our experience of successful treatment with venovenous (VV) ECMO for negative pressure pulmonary hemorrhage (NPPH) following foreign body obstruction
Summary
Negative pressure pulmonary edema (NPPE) and hemorrhage (NPPH) are uncommon problems resulting from upper airway obstruction [1]. A previous report showed that NPPE and NPPH resolve rapidly with short-term ventilatory support [2]. NPPE and NPPH can lead to lifethreatening respiratory insufficiency requiring extracorporeal membrane oxygenation (ECMO) [3]. Active hemorrhage might be a contraindication for ECMO, it is considered for life-threatening acute respiratory distress syndrome (ARDS) when the underlying condition is reversible despite optimal ventilatory support [4]. The application of ECMO to older patients is not contraindicated [8, 9]. This paper presents our experience of successful treatment with venovenous (VV) ECMO for NPPH following foreign body obstruction
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