Evaluation of veno-venous extracorporeal membrane oxygenation in post pneumonectomy pulmonary edema ; Évaluation de l’oxygénation extra corporelle veino-veineuse dans la prise en charge de l’œdème pulmonaire post pneumonectomie

Post pneumonectomy pulmonary edema (PPE) is a rare but threatening complication. Recentdevelopment of veno venous extra corporeal membrane oxygenation (VVECMO) in the acute respiratorydistress syndrome (ARDS) may enhanced its prognosis. In our Department, since 2010, patients whosuffered of PPE were treated by VVECMO. The aim of this study is to evaluate the benefit of thistreatment in comparison with a control period (2004-2010) when patients were treated withconventional measures. Secondary objective was to look for all associated factors of postpneumonectomy acute respiratory failure (ARF). Method: All pneumonotomy performed in our centerbetween January 2004 and January 2018 were included. PPE was defined by: Berlin ARDS definition andthe absence of intercurrent disease. ARF was defined by the association of hypoxemia (PaO2/FiO2<300mmHg) and need for mechanical ventilation (NIV or ETI). Demographics data, ARF and PPE incidenceas well as in hospital mortality were recorded. Results: On 368 pneumonectomy performed on the studyperiod, 49 (13,3%) developed an ARF and among those 49 patients, 11 (3%) were PPE ARDS. On the 11patients, 6 were treated by VVECMO with a 100% survival. The other 5 patients of the control periodwithout VVECMO died. In multivariate analysis, ARF was associated with SAPS2 at the intensive care unitadmission and right pneumonectomy. Conclusion: On this rare complication, VVECMO is a real stepforward for survival among patients with PPE ; L’œdème pulmonaire post pneumonectomie (OPPP) est une complication rare souvent mortelle. Ledéveloppement récent de l’ECMO veino veineuse (ECMOVV) dans les syndromes de détresse respiratoireaiguë (SDRA) pourrait permettre d’améliorer le pronostic de cette complication. Dans notreétablissement, depuis 2010 les patients présentant un OPPP ont été traités par ECMOVV. L’objectifprincipal est d’évaluer le bénéfice de ce traitement par rapport à une période contrôle (2004-2010) oùles patients étaient traités de façon conventionnelle. L’objectif secondaire est ...