Massive Pulmonary Hemorrhage Following Pulmonary Endarterectomy

Yıl 2019, Cilt: 22 Sayı: 2, 134 - 136, 15.08.2019

Mustafa Mert Özgür Mehmed Yanartaş Serpil Taş Ece Altınay Halide Oğuş Atakan Erkılınç Bedrettin Yıldızeli

Öz

Perioperative reperfusion injury, acute right heart failure, and massive pulmonary hemorrhage are the most
important factors determining mortality following pulmonary endarterectomy operation (PEA). Our approach
for the treatment of intraoperative pulmonary hemorrhage following pulmonary endarterectomy is discussed.
We retrospectively studied a PEA case with massive pulmonary hemorrhage that occurred in 2017. We used
endobronchial blocker to ensure that the bleeding is stopped and used extracorporeal membrane oxygenation
(ECMO) for respiratory and hemodynamic requirements. ECMO is a good alternative for most of the pre- and
postoperative major complications of PEA. Combined use of endobronchial blocker and ECMO could be a
useful treatment method for massive pulmonary hemorrhage following pulmonary endarterectomy.

Anahtar Kelimeler

PEA, pulmonary endarterectomy, ECMO, pulmonary hemorrhage

Pulmoner Endarterektomi Sonrası Oluşan Masif Pulmoner Kanamanın Yönetimi

Öz

Pulmoner endarterektomi (PEA) operasyonu sonrası gelişen perioperatif reperfüzyon hasarı, akut sağ kalp
yetmezliği ve masif pulmoner hemoraji gibi komplikasyonlar mortalite ve morbiditeyi belirleyen en önemli
faktörlerdir. Bu olguda pulmoner endarterektomi operasyonunda intraoperatif masif pulmoner hemoraji gelişen hastada tedavi yönetimimiz tartışıldı. 2017 yılında yapılan pulmoner hemoraji gelişen PEA operasyonu
geriye dönük olarak incelendi. Bu olguda masif kanamayı durdurmak için endobronşiyal bloker kullanıldı.
Hemodinamik ve respiratuvar gereksinimden dolayı da ekstrakorporeal membran oksijenizasyonu (ECMO)
kullanıldı. ECMO kullanımı, PEA operasyonlarında per ve postoperatif gelişen birçok komplikasyon için
alternatif bir yaklaşımdır. Bizim olgumuzda olduğu gibi endobronşiyal bloker ve Ecmo'nun birlikte kullanımı
PEA sonrası gelişen masif pulmoner hemorajide etkin ve kullanışlı bir yaklaşım olabilir.

Anahtar Kelimeler

Pulmoner endarterektomi, PEA, PTE, ECMO, pulmoner hemoraji

Kaynakça

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