Respiratory failure of two sp gastric bypass patients and subsequent rescue with extracorporeal membrane oxygenation

Mongero, L. B.; Beck, J. R.; Charette, K. A.; Stewart, A.
January 2006
Perfusion;Jan2006, Vol. 21 Issue 1, p73
Academic Journal
Severe obesity is a chronic condition that is difficult to treat through diet and exercise alone. Gastrointestinal surgery for obesity (bariatric surgery) alters the digestive process by either restrictive surgical alterations or malabsorptive operations. Some 10–20% of patients who have weight-loss surgery require follow-up operations to correct complications. Hypoxemia after gastric bypass surgery for morbid obesity, a reported complication, can occur as early as 24 h post surgery. Two patients presented with severe hypoxia and were placed on veno-venous extracorporeal membrane oxygenation (ECMO). Patient No. 1 had an obstruction of the alimentary limb of the gastric bypass due to suture adhesions, and patient No. 2 had an incarcerated diaphragmatic hernia. While on ECMO, ventilation using a protective strategy (60% FiO2, pressure-controlled ventilation inspiratory pressure (PCV) IP 25–27, positive end-expiratory pressure (PEEP) 10–14, permissive hyper-capnia) was employed. An inflow cannula to the level of the right atrium served as arterial outflow from the circuit to the patient, while the femoral vein served as venous inflow to the ECMO circuit. Although ECMO in adult respiratory failure is often used as the last resort due to serious associated adverse events, we report two patients with life-threatening complications from gastric bypass who were rescued, resuscitated to day 7, and uneventfully discharged from the hospital to home.


Related Articles

  • Endoscopic Findings of Asymptomatic Patients One Year After Roux-en-Y Gastric Bypass for Treatment of Obesity. Spinosa, Sergio; Valezi, Antonio // Obesity Surgery;Sep2013, Vol. 23 Issue 9, p1431 

    Background: In the late post-operative period, the necessity of performing an upper gastrointestinal endoscopy (GIE) to check for complications is controversial. Some authors suggest it should be routine for all patients, others selectively, but not all patients with endoscopic abnormalities are...

  • When Diets Don't Work: Losing Weight With Prescription Drugs Or Surgery. Forman, Adrienne // Environmental Nutrition;Jul2005, Vol. 28 Issue 7, p1 

    Focuses on the alternative treatment for obesity. Definition of obesity; Application of drugs to suppress appetite and reduce dietary fat absorption; Calculation of the body mass index; Description of the obesity surgeries, the Roux-en-Y Gastric Bypass and the Adjustable Gastric Bypass Banding. ...

  • Gastric bypass surgery improves as experience broadens.  // New York Amsterdam News;6/16/2005, Vol. 96 Issue 25, p34 

    The article focuses on a study reported in the journal "Archives of Surgery," a publication of the American Medical Association, which states that with surgeons performing more gastric bypass operations, the results are improving and the risks decreasing. Gastric bypass surgery, also known as...

  • The use of continuous renal replacement therapy in series with extracorporeal membrane oxygenation. Santiago, Maria J.; Sánchez, Amelia; López-Herce, Jesús; Pérez, Rosario; del Castillo, Jimena; Urbano, Javier; Carrillo, Angel // Kidney International;Dec2009, Vol. 76 Issue 12, p1289 

    A large percentage of patients on extracorporeal membrane oxygenation (ECMO) require continuous renal replacement therapy (CRRT) usually performed through a different venous access or by introducing a filter into the ECMO circuit. Here, we evaluated the efficacy and safety of including a CRRT...

  • ECMO and endogenous carboxyhemoglobin formation. Tripathi, Ravi S.; Papadimos, Thomas J. // International Journal of Critical Illness & Injury Science;Jul-Dec2011, Vol. 1 Issue 2, p168 

    The article describes a case of extremely high and poisonous carboxyhemoglobin (COhb) level in a 41-year-old patient on extracorporeal membrane oxygenation (ECMO). The patient presented with shortness of breath and hypoxemia, requiring mechanical ventilation. The patient was given inhaled nitric...

  • Rat model of veno-arterial extracorporeal membrane oxygenation. Ali, Ayyaz A.; Downey, Peter; Singh, Gopal; Wei Qi; George, Isaac; Takayama, Hiroo; Kirtane, Ajay; Krishnan, Prakash; Zalewski, Adrian; Freed, Darren; Large, Stephen R.; Ashley, Euan A.; Leon, Martin B.; Bacchetta, Matthew; Ali, Ziad A. // Journal of Translational Medicine;2014, Vol. 12 Issue 1, p1 

    Background We aim to develop a rat model of veno-arterial extracorporeal membrane oxygenation (VAECMO). Methods VA-ECMO was established in twelve Male Sprague-Dawley rats (250-350 g) through cannulation of the right jugular vein for venous drainage and the right femoral artery for arterial...

  • Nosocomial infections during extracorporeal membrane oxygenation. O'Neill, J.; Schutze, G.; Heulitt, M.; Simpson, P.; Taylor, B.; O'Neill, J M; Schutze, G E; Heulitt, M J; Simpson, P M; Taylor, B J // Intensive Care Medicine;Aug2001, Vol. 27 Issue 8, p1247 

    Objective: To examine trends in nosocomial infection associated with Extracorporeal Membrane Oxygenation (ECMO).Design: Retrospective review of all patients who underwent ECMO over a 4-year period at our institution; specifically, examining reasons for placement and...

  • Cardiac ECMO for biventricular hearts after paediatric open heart surgery. Chaturvedi, R. R.; Macrae, D.; Brown, K. L.; Schindler, M.; Smith, E. C.; Davis, K. B.; Cohen, G.; Tsang, V.; Elliott, M.; de Leval, M.; Gallivan, S.; Goldman, A. P. // Heart;May2004, Vol. 90 Issue 5, p545 

    Objective: To delineate predictors of hospital survival in a large series of children with biventricular physiology supported with extracorporeal membrane oxygenation (ECMO) after open heart surgery.Results: 81 children were placed on ECMO after open heart surgery. 58%...

  • A comparison of radiographic signs of pulmonary inflammation during ECMO between silicon and poly-methyl pentene oxygenators. Khoshbin, Espeed; Dux, Anthony E. W.; Killer, Hilliary; Sosnowski, Andrzej W.; Firmin, Richard K.; Peek, Giles J. // Perfusion;Jan2007, Vol. 22 Issue 1, p15 

    Introduction: The inflammatory response caused by extracorporeal membrane oxygenation (ECMO) is clearly visible within the first 24 h of cannulation. The inflammatory process affects all areas of the lung, even areas previously spared by the primary disease. Objective: To compare the change in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics