Extracorporeal Membrane Oxygenation Rescue for Severe Aspiration Pneumonitis in Two Patients after Roux-en-y Gastric Bypass Procedure

Authors

Melissa M Felinski
Daniyal Abbas
Peter A Walker
John A Primomo
Tanyaradzwa M Kajese
Biswajit Kar
Igor D Gregoric
Igor Banjac
Lisa Janowiak
Sriram Nathan
Rahat Hussain
Sheilendra S Mehta
Kulvinder S Bajwa
Shinil K Shah
Bindu Akkanti

Publication Date

9-1-2021

Journal

The Journal of Extracorporeal Technology

Abstract

Roux-en-y gastric bypass (RYGB) is one of the most common weight loss surgical procedures performed in the United States. Early post-operative small bowel obstruction is a rare but potentially morbid, complication of RYGB. We report two patients who underwent RYGB and required subsequent treatment for a post-operative small bowel obstruction. Their post-operative course was complicated by severe aspiration pneumonitis leading to hypoxemic respiratory failure requiring rescue with femoral veno-venous extracorporeal membrane oxygenation (V-V ECMO). Both patients were successfully extubated, weaned off V-V ECMO support, and discharged to home. These cases highlight the potential role of V-V ECMO for patients who have undergone RYGB and develop severe aspiration pneumonitis. They also highlight the need for cautionary use of gastrografin in RYGB patients. Early engagement of a multidisciplinary team experienced with adult ECMO is vital for favorable patient outcomes.

Keywords

extracorporeal membrane oxygenation, gastrografin, aspiration pneumonia, roux-en-y gastric bypass, morbid obesity

Comments

PMID: 34658412