393
KAZUISTIKA4321200011157120176236269319376408468532
/4878200011133
CASE4936200011155117168223
REPORT5184200011157113168230289344
Our331232009755100127
experience34563200974079125167194213254299336376
with38493200975978105150
VV40163200974593
ECMO‑assisted41263200974086151207235274306338357389417457503
surgery:46463200973276103148189216257275
case49383200973575107148
report51033200972667113158185215
series5335320097317299119160192
|5584190011126
37565419001114385
/24348040010732
Anest25118040010752100145178207
intenziv273880400107196794136184221240282
Med.30398040010770115165181
2025;36(1):34-383239804001074487129173186230273297337354369413458487528571
/38558040010732
ANESTEZIOLOGIE39528040010753112156200245290342362425468527586607651
A46248040010753
INTENZIVNÍ4698804001071978123168227277297345405426
MEDICÍNA51468040010770114173194248268327381
www.aimjournal.cz4258040010765133201214257275349367415463490539579598614654693
In565524001071967
elective650524001074363107148178197238281
VV949524001074696
ECMO‑assisted1063524001074293163224254295328362380412441484534
surgeries,1615524001073380107155199226245289322338
the1971524001072876120
duration2109524001074997123165192210258307
of2434524001074872
ECMO2524524001074293163224
was27655240010765107140
one425538001074898142
day,594538001075091130142
whereas7635380010765115159186230270304
in1094538001071967
acute1188538001074183131159203
VV1417538001074798
ECMO‑assisted1541538001074394165227257298332366385418447490541
surgeries,2109538001073481108157201228248292326343
the2478538001072977122
median26275380010774119170189230278
duration425552001074996123164192210258307
of752552001074872
ECMO844552001074293163224
was10885520010765106140
912485520010744
(2-15)131255200107246692130168191
days.1523552001074989128162179
None17225520010757106155199
of1941552001074872
the2033552001072876120
patients2173552001075091119137181229256291
died2484552001074968111161
during2666552001074896122142189239
surgery.425566001073481107155199226269281
In724566001071967
elective809566001074463107148178197238282
cases,1109566001074081115159192208
the1336566001072776120
30-day1474566001074488117169209248
mortality17405660010774123150181222241259287330
was20885660010765106140
0%.22465660010744111129
In2393566001071967
acute2478566001074181129157200
cases,2696566001074082115159193209
the425580001072878124
30-day576580001074590121174216256
mortality8595800010775125153185228248267296340
was12265800010767109144
37.5%139758000107458794140206
(all163158000107246483103
patients1761580001075194122142187236264300
died2089580001075069114166
of2282580001074974
complications2384580001074189165216236255297340368388437487521
related42559400107277089130157200250
to701594001072875
ARDS).802594001075398157199222236
The1064594001074292136
median12265940010774119169188228276
of1529594001074872
hospital1627594001074897131180199227269288
length1941594001071963112161190238
of2206594001074872
stay2304594001073463104143
was24735940010766107141
726405940010744
(5-10)271059400107246794133173196
days425608001074990128162
and607608001074189138
30765608001074488
(19-77)872608001072464102131171214239
days1130608001074990129163
in1312608001071967
elective1399608001074363107148178197238281
and1700608001074189138
in1858608001071967
acute1944608001074182130158200
cases,2164608001074082115159193209
respectively.2392608001072770104153198239269288329372392432444
Discussion4256320015382123178237310363418459524597
The425650001074291135
primary57665000107507796169209235278
indication870650001071967116134174215242261308357
for124365000107247198
VV1357650001074696
ECMO‑assisted1469650001074293163223252293326359377409438480530
surgery2015650001073480107154198224267
in2298650001071967
our2381650001074896122
152519650001074481
patients2617650001074991117136180227254289
was4256640010765106140
the586664001072876120
difficulty72766400107496892119139179227246274316
or1065664001074774
impossibility1161664001071892141190224257275325344363381409452
of1634664001074872
one‑lung1727664001074897141170190238286335
ventilation2083664001074184132159178197237264283331380
due2484664001074996141
to2646664001072774
lung2741664001071967115164
impairment425678001071990139179197222295338385411
or852678001074773
previous941678001074975117156175222269301
lung1257678001071965112160
resections.1433678001072668101144184213231278326358374
Impossible1822678001071991139187220252270318337380
selective221767800107337695138178207225265307
intubation254067800107196591138186227253271318365
was4256920010765107141
the592692001072876121
reason739692001072770111144193242
in1007692001071968
two1101692001072896144
cases1271692001074182116160194
only1492692001074897116156
(tracheomalacia,167569200107245077119160208253302377418437478519537578594
external2295692001074484115158185234275294
tracheal261569200107285597138186231271290
compression).425706001074087161210237280314347366414462484497
The942706001074292136
risk109970600107264678116
of1236706001074872
complications1328706001074087161211230249289330358376424473506
and1855706001074189138
mortality20147060010773122149180221240259287329
during2364706001074996123142190239
elective2624706001074463107148178197238281
VV425720001074695
ECMO‑assisted537720001074192161222251291324357375407436478527
surgery1081720001073380106153197223265
was13637200010764105138
very1517720001074183110152
low.1685720001071967131144
This1845720001074291109141
implies2003720001071891140159177221254
that2273720001072876116143
a24327200010740
small24897200010733106146164183
group2688720001074975121169218
of425734001074872
patients519734001075091118137181229256291
who8327340010765113162
would10167340010765112161179229
not1267734001074896124
normally1413734001074896123197238257276316
be1751734001074994
able1867734001074191110154
to2043734001072875
undergo2140734001074896145189216264312
surgery2474734001073481107155199226269
due2765734001074996140
to425748001072874
their521748001072876120139165
inability708748001071967107157176195213241284
to1014748001072874
tolerate111074800107287494138164206233276
one‑lung1407748001074897141170190238286335
ventilation1764748001074184132159178196237264283331379
or2165748001074875
selective226274800107337797141182212231272315
intubation259974800107196793141191233260278425762001074897
could547762001074087135154203
safely77676200107337599142162202
undergo1003762001074896145190216264312
lung1341762001071967115164
resections.1531762001072669103147188219237285334367384
A19407620010753
significant2019762001073352101149167191211251293341368
mortality24127620010774122149180222241259287330
rate276776200107276996138
occurred425776001074991131180208236280331
in784776001071968
acute879776001074284133162206
cases,1112776001074184118163198215
and1354776001074291142
bleeding1523776001075171117163214234283333
frequently188477600107245397148197242292319339381
complicated2292776001074189165216236255297339367411462
the2782776001072878123
postoperative3047524001075099133162209259304330372399418459503
course,3576524001074087135162196240255
partly3857524001075092118149169209
due4092524001074997141
to4259524001072875
the4360524001072876121
anticoagulation4507524001074189116135175222264313361380420448467515563
required5097524001072669119167186212255306
for542952400107237198
ECMO.3047538001074293163224238
However,33075380010757105170213254297324336
the3664538001072877121
underlying3807538001074796145189215235275295342392
disease4221538001074967100144184218262
caused4505538001074081129162206256
the4783538001072876120
mortality,49255380010774123150181222241259287330341
and5288538001074189139
all544953800107416078
ECMO‑associated3047552001074293163224254294328361410451469510537579629
complications3696552001074087161210230249289330357376424473506
resolved.4222552001072669103151171212255305321
Jet3187566001073175103
ventilation,3312566001074184132159178197237265283331380395
apneic3730566001074190139183202242
ventilation3994566001074184132159178197237264283331380
with4396566001076584112161
high-flow4579566001074867116164192216239287352
oxygen,4953566001074886129177221270285
or5260566001074875
intubation5358566001071866931413047580001075092119138186235
through3309580001072776102150198248296
the3632580001072776120
surgical3779580001073381107156175215257276
field408158000107244488107157
into426458000107196794141
the4431580001072877121
distal4579580001074968101130171190
trachea479658000107285597137186230270
can5093580001074082130
provide5250580001074977124164184233278
oxygenation/ventilation3047594001074988132182228277319347367416467500542587637664684704745774793843893
in3967594001071969
situations406359400107345382132174202222271321355
where44465940010766116162189233
selective4707594001073480100145188219239281325
intubation506059400107196896146197239268287337387
is5474594001071953
impossible3047608001071992142191224258276325345389
due3455608001074996140
to3614608001072875
obstructions,3708608001074898131160187235276306325373422455471
tracheomalacia,419760800107285597137185229278353393412453493512552568
or4784608001074875
airway487860800107415986153195234
surgery5131608001073380106155199225268
[3].54186080010926729555126080010716
Barotrauma3047622001074586112159186212254301374414
can3477622001074081129
complicate3622622001074086160209228246286327354396
jet403462200107196390
ventilation,4140622001074184131158176195235262280328376391
which45476220010765113131171219
limits4782622001071937110128156190
its498962200107184681
use5086622001074780124
in5226622001071966
obese5308622001074898142175219
patients3047636001075193122141186236263299
with3374636001076686115164
COPD35666360010752111158217
[3].38106360010926749739066360010716
Endotracheal3949636001074392143193221248291333382428469489
oxygenation,4465636001074988132182227277319347366416466482
which49746360010766116136177226
involves5228636001071968109158178220265299
high3047650001074969119169
oxygen3244650001074988132182228278
flow354965000107244898164
through3741650001072878105154204255304
a40736500010742
small41426500010735110152172191
probe,4361650001075179128179226241
is4630650001071953
an4710650001074292
easy4829650001074586121163
technique5020650001072872115165214234284333379
for5426650001072474102
oxygenation.3047664001074886129177221270310337356404453469
However,35376640010757106170214255298324336
without3895664001076584112160208257285
ventilation,4201664001074184132159178197237264283331380395
it4618664001071947
can4686664001074082130
cause4837664001074182130163207
hypercapnia,5065664001074887138183209248290339388406446462
which30476780010765114132172220
can3288678001074082130
lead3439678001071963103152
to3612678001072875
hypercapnic3708678001074886137182208247289338387406446
acidosis.4175678001074181100149197231249282298
Furthermore,4494678001074288114145193237264338387414457471
the4986678001072876120
duration5127678001074997123165192211259307
of5455678001074872
apnea,3047692001074190139183223239
ideally3306692001071968112153171190230
limited3556692001071938111130158200250
to3827692001072774
303921692001074488
minutes4029692001077492140188216258292
[4],43426920010926699344366920010716
frequently447269200107235194144192236284311330370
fails486269200107246684103136
to5018692001072874
provide5113692001074976123164183232276
adequate54106920010740903047706001074493141181208250
time3314706001072846119163
for349470600107237198
surgery.3608706001073480107155198225268279
Periodical3904706001074587113132180230248289330349
cross-field4269706001074066113147180206230250293313361
intubations464770600107196693141190232259277325373406
may50707060010773114152
prolong5239706001074976123143191239288
surgery3047720001073481107155199226269
time3338720001072847120165
and3525720001074189138
require3686720001072770119167186212255
frequent396472000107235194144191235284310
cooperation4297720001074087136186231257299326345393441
between4761720001075095122190233278326
the5110720001072876120
surgical5253720001073380107155173214255274
and3047734001074189138
anesthesia3205734001074189133167196244288322340380
teams.3605734001072871111184217234
Similar3187748001074159131149167207233
ventilation3435748001074183130156175193233259277324372
techniques,3823748001072769109157204222270316359392408
extended4247748001074382112153200249292341
by4604748001074988
intermittent470874800107186591133159232250277307349396422
conventional51467480010740851331722142612873063533047762001074888107
ventilation,3171762001074083131157176194235262280328376391
can3579762001074081129
also372476200107415992140
be3880762001075094
used3991762001074780124173
for418176200107237097
patients4294762001075091118137180228255289
in4599762001071967
whom46827620010765113161235
airways493376200107415985153194232266
could5215762001074087134153202
be5433762001075094
secured,3047776001073478119167193236286302
but3369776001075098126
one‑lung3515776001074897141170190238286335
ventilation3871776001074083132158177196237264282330379
is4270776001071952
not4342776001074897124
possible4486776001075099133166184234253297
or4804776001074875
is4899776001071951
associated4971776001074174107156197215256283325375
with5367776001076584112160
Fig.425298001255687137164
3.605298001255479
Bronchopleural729300001074369113160197243288334353391436462505523
fistulation12683000010723427198143161206232250296342
after162630000107466897134160
right-sided180230000107264489135160184215232277316361
pneumonectomy2179300001074692131176247293339377415443486558593
Fig.42560001255687137164
2.60560001255481
Persistent73162001074379105136153183209245292317
pneumothorax106462001074592130176247292318364409435478515
in159562001071965
the167662001072672111
field1803620010723428098143
of196262001074568
panlobular204662001074692138156201247292311356381
emphysema2444620010738109154201236267305376421