The first use of extracorporeal mechanical oxygen on a 63-year old male with heart failure and cardiopulmonary arrest
Inroduction: Extracorporeal membrane oxygenation is a machine that provides extracorporeal circulation and gas exchange by using extrathoracic cannulation. Initially this machine has been used for patients with respiratory and heart failure.
Presentation of Case: A 63-year old male with hypertension and chronic obstructive pulmonary disease presented with substernal chest pain accompanied by diaphoresis. ECG showed ST elevation at the inferior wall and 2D echo showed overall preserved left ventricular systolic function with an ejection fraction of 60% (Teicholz) and mild hypokinesia of the inferior interventricular septum and inferior left ventricular free wall. Coronary angiogram showed severe 2-vessel coronary artery disease at the mid to distal PLB. During PCI, the patient went into cardiopulmonary arrest. The patient was revived, started on inotropes and placed on an Extracorporeal Membrane Oxygenation (ECMO) machine. The patient’s status gradually improved over a span of two weeks.
Discussion and Conclusion:
Extracorporeal membrane oxygenation (ECMO) is a mechanical cardiopulmonary bypass circuit temporarily used for patients with potentially cardiac and/or respiratory failure which was first introduced in 1972 as a tool enabling high success rate in open heart surgery. Initiation of ECMO include acute severe cardiac or pulmonary failure that is potentially reversible and unresponsive to conventional management.