Medicina Pulmonar e Respiratória

Unexpectedly Lethal Hemothorax in the ICU

Abstract

Sakir Akin, Corstiaan A den Uil, Dinis Dos Reis Miranda and Robert J van Thiel

Chest-tube placement is one of the most common procedures performed to evacuate pleural effusion. Several types and sizes of chest tubes are available. Although chest-tube placement is straightforward, it may be associated with significant morbidity and mortality. We describe here a hemothorax in a patient with Veno-venous extra corporeal membrane oxygenator (VV-ECMO) which was treated with chest-tube placements by Seldinger technique.

VV-ECMO is increasingly being used as a bridge to recovery or transplantation in patients with severe pulmonary disease. Unexpected complications, like a hemothorax can cause severe hemodynamic derangement. Treatment of this complication remains challenging for several reasons in patients assisted by VV-ECMO. Introduction of a chesttube should therefore be regarded as a high risk intervention in VV-ECMO patients.