VV ECMO assisted surgery for thoracic infections - case report series
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| Year of publication | 2026 |
| Type | Appeared in Conference without Proceedings |
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| Description | VV ECMO assisted surgery for thoracic infections - case report series Abstract Veno-venous extracorporeal membrane oxygenation (VV ECMO) is a method of extracorporeal support providing adequate oxygenation and elimination of carbon dioxide. By using this method, we are able to provide surgical treatment to highly selected patients who would otherwise be unable to undergo thoracic surgery especially with ARDS. This case series presents our experience with VV ECMO-assisted thoracic surgery in patients with ARDS and thoracic infection. Presentation of Cases Between December 2020 and December 2025, 7 VV ECMO-assisted thoracic surgeries were done at St. Anne’s University Hospital in Brno. Patients included 2 women and 5 men with a mean age of 48 years. A total of 33 emergency surgeries were performed on this patients and 15 of which were performed using VV ECMO. Indication for surgery therapy was four times empyema (once together with bronchopleural fistula, once with lung absces), once for lung absces and four times for lung necrosis. Six procedures were done for complication of primary surgery (hemothorax 4x, bronchopleural fistula 2x). It was done four times drainage (once VATS, three open), four times were done wedge resection, five times lobectomy and two times tamponade (all open). 30d postoperative mortality was 1 (14 %) and 90d postoperative mortality was 2 (28 %). The average length of hospital stay for surviving patients was 62 days. All patients who died had an upward trend in inflammatory parameters (CRP, leukocytes) at the time of surgery. Conclusion Patients with respiratory failure (ARDS) requiring surgical treatment for thoracic infections may also benefit from VV ECMO. In this case, morbidity and post-operative mortality are very high, but related to the underlying disease rather than the surgical treatment itself. Timing the ideal condition for performing surgery in a septic patient with ARDS is a challenge for all therapeutic team (especially intensive care physician and thoracic surgeon), cause there are no clear recommendations. In these patients, it is usually necessary to perform repeated operations complicated mainly by bleeding. |