Our Summary

This research paper is about a procedure called Extracorporeal membrane oxygenation (ECMO) which is a method used during chest surgeries, particularly lung transplants. It’s becoming more common to use ECMO to prepare patients for a transplant. The best results have been seen when patients are awake during this procedure. ECMO has mostly replaced the use of the heart-lung machine during surgery, and it’s also used to treat and prevent any malfunctions of the transplanted lung. The tools and techniques used in ECMO have improved, allowing doctors to customize the procedure based on the patient’s breathing, blood flow, and expected duration of treatment.

FAQs

  1. What is Extracorporeal membrane oxygenation (ECMO) and when is it used?
  2. Why is it beneficial for patients to stay awake during the ECMO procedure?
  3. How has ECMO evolved with improved tools and techniques to better suit patient needs?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung surgery is to follow all pre-operative instructions carefully, including any dietary restrictions, medication adjustments, and breathing exercises. It is important to communicate openly with your healthcare team about any concerns or questions you may have before the surgery. Additionally, make sure to follow all post-operative care instructions closely, including proper wound care, medication management, and physical therapy. It is important to attend all follow-up appointments to monitor your recovery progress and address any issues that may arise. By following these guidelines, you can help ensure a successful outcome and a smooth recovery from lung surgery.

Suitable For

Patients who are typically recommended for lung surgery include those with end-stage lung disease, such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, pulmonary fibrosis, and pulmonary hypertension. These patients may have severe symptoms that significantly impact their quality of life and may not respond well to other treatments such as medications or pulmonary rehabilitation.

In addition, patients who have lung cancer that is localized to the lung and has not spread to other parts of the body may be recommended for lung surgery. Surgery is often the preferred treatment for early-stage lung cancer, as it can potentially cure the disease and provide the best chance for long-term survival.

Patients who have severe lung infections, such as pneumonia or bronchiectasis, may also be recommended for lung surgery if other treatments have not been effective in controlling the infection. Surgery may be necessary to remove parts of the lung that are severely damaged or infected in order to improve the patient’s breathing and overall health.

Overall, the decision to recommend lung surgery for a patient is based on a thorough evaluation of the patient’s medical history, symptoms, lung function, and overall health. The goal of surgery is to improve the patient’s quality of life, relieve symptoms, and potentially cure or control the underlying lung condition.

Timeline

Before lung surgery:

  1. Patient undergoes a thorough evaluation by a medical team to determine if they are a suitable candidate for lung surgery.
  2. Pre-operative tests such as blood work, imaging scans, and lung function tests are conducted to assess the patient’s overall health and lung function.
  3. Patient meets with their surgeon and anesthesiologist to discuss the surgery, potential risks, and expected outcomes.
  4. Patient may undergo prehabilitation exercises to strengthen their lungs and improve their overall physical condition before surgery.
  5. Patient is admitted to the hospital on the day of surgery and prepared for the procedure.

After lung surgery:

  1. Patient is closely monitored in the intensive care unit (ICU) immediately after surgery to ensure their vital signs are stable.
  2. Patient may be placed on a ventilator to assist with breathing if needed.
  3. Patient may be transferred to a step-down unit or regular hospital room once they are stable and showing signs of recovery.
  4. Patient undergoes physical therapy to help regain strength and mobility.
  5. Patient is closely monitored for any signs of complications such as infection, blood clots, or rejection of the transplanted lung.
  6. Patient may undergo follow-up appointments with their medical team to track their progress and adjust their treatment plan as needed.

What to Ask Your Doctor

  1. What is the purpose of using ECMO during my lung surgery?

  2. How will ECMO benefit me during and after the surgery?

  3. What are the potential risks and complications associated with ECMO?

  4. How long will I need to be on ECMO during the surgery?

  5. Will I be awake during the ECMO procedure? If so, what can I expect during the procedure?

  6. How will ECMO help to prevent malfunctions of the transplanted lung?

  7. What are the success rates of using ECMO during lung surgery?

  8. Are there any alternative treatment options to ECMO for my condition?

  9. How will my recovery be different with ECMO compared to traditional methods of lung surgery?

  10. What follow-up care will be needed after the surgery, particularly related to the use of ECMO?

Reference

Authors: Aigner C, Slama A, Valdivia D. Journal: Zentralbl Chir. 2019 Feb;144(1):100-105. doi: 10.1055/a-0624-9612. Epub 2018 Jun 14. PMID: 29902830