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Master Thesis

Évaluation de l’oxygénation extra corporelle veino-veineuse dans la prise en charge de l’œdème pulmonaire post pneumonectomie

Abstract : Post pneumonectomy pulmonary edema (PPE) is a rare but threatening complication. Recent development of veno venous extra corporeal membrane oxygenation (VVECMO) in the acute respiratory distress syndrome (ARDS) may enhanced its prognosis. In our Department, since 2010, patients who suffered of PPE were treated by VVECMO. The aim of this study is to evaluate the benefit of this treatment in comparison with a control period (2004-2010) when patients were treated with conventional measures. Secondary objective was to look for all associated factors of post pneumonectomy acute respiratory failure (ARF). Method: All pneumonotomy performed in our center between January 2004 and January 2018 were included. PPE was defined by: Berlin ARDS definition and the absence of intercurrent disease. ARF was defined by the association of hypoxemia (PaO2/FiO2< 300mmHg) and need for mechanical ventilation (NIV or ETI). Demographics data, ARF and PPE incidence as well as in hospital mortality were recorded. Results: On 368 pneumonectomy performed on the study period, 49 (13,3%) developed an ARF and among those 49 patients, 11 (3%) were PPE ARDS. On the 11 patients, 6 were treated by VVECMO with a 100% survival. The other 5 patients of the control period without VVECMO died. In multivariate analysis, ARF was associated with SAPS2 at the intensive care unit admission and right pneumonectomy. Conclusion: On this rare complication, VVECMO is a real step forward for survival among patients with PPE
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02885284
Contributor : Université Paris Descartes - Scd <>
Submitted on : Tuesday, June 30, 2020 - 3:27:53 PM
Last modification on : Sunday, January 10, 2021 - 3:24:29 AM

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  • HAL Id : dumas-02885284, version 1

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Charles Moulin. Évaluation de l’oxygénation extra corporelle veino-veineuse dans la prise en charge de l’œdème pulmonaire post pneumonectomie. Médecine humaine et pathologie. 2019. ⟨dumas-02885284⟩

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