Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2022; 10(25): 8974-8979
Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.8974
Extracorporeal membrane oxygenation for lung cancer-related life-threatening hypoxia: A case report
Seung Soo Yoo, Shin Yup Lee, Sun Ha Choi
Seung Soo Yoo, Shin Yup Lee, Department of Internal Medicine, Kyungpook National University, Daegu 41404, South Korea
Sun Ha Choi, Lung Cancer Center, Kyungpook National University Chilgok Hospital, Daegu 41404, South Korea
Author contributions: Yoo SS and Choi SH conceived and designed the experiments; Yoo SS and Choi SH performed the experiments; Yoo SS, Lee SY, and Choi SH acquired clinical data; Yoo SS, Lee SY, and Choi SH wrote the main manuscript text; all authors reviewed the manuscript.
Informed consent statement: Written informed consent was obtained from the patient to publish this report in accordance with the journal's patient consent policy.
Conflict-of-interest statement: The authors have declared that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sun Ha Choi, MD, PhD, Doctor, Lung Cancer Center, Kyungpook National University Chilgok Hospital, 807, Hoguk-ro, Buk-gu, Daegu 41404, South Korea. sunha20@knu.ac.kr
Received: February 21, 2022
Peer-review started: February 21, 2022
First decision: March 24, 2022
Revised: April 4, 2022
Accepted: July 22, 2022
Article in press: July 22, 2022
Published online: September 6, 2022
Processing time: 186 Days and 7.3 Hours
Abstract
BACKGROUND

Life-threatening hypoxia can occur in patients with lung cancer due to bronchial obstruction. Extracorporeal membrane oxygenation (ECMO) can be used as a bridge therapy for patients with severe hypoxia not relieved by conventional mechanical treatment. However, the usefulness of chemotherapy in patients with lung cancer receiving ECMO therapy is not well known.

CASE SUMMARY

A 53-year-old man visited the emergency room with worsening dyspnea for 1 mo. A series of imaging and diagnostic tests were performed, and stage IIIB (cT4N2M0) lung cancer was eventually diagnosed. On hospital day 3, he experienced dyspnea and hypoxia that was not relieved with oxygen support via a high-flow nasal cannula. ECMO was initiated because his respiratory condition did not improve even with mechanical ventilation. The patient then underwent gemcitabine/cisplatin chemotherapy without dose reduction while on ECMO. After two cycles of chemotherapy, there was a decrease in the size of the primary tumor in the right main bronchus. After the completion of concurrent chemoradiotherapy, a computed tomography scan revealed further improvement in the right main bronchus narrowing. Eight months after a lung cancer diagnosis, the patient did well without any dyspnea.

CONCLUSION

ECMO is a potential bridge therapy for respiratory failure in patients with central airway obstruction secondary to lung cancer.

Keywords: Extracorporeal membrane oxygen; Lung cancer; Hypoxia; Respiratory failure; Chemoradiotherapy; Case report

Core Tip: Extracorporeal membrane oxygenation can be selected as an important salvage treatment for patients with severe cardiopulmonary dysfunction caused by lung cancer and other malignant tumors until the patients are stabilized or even cured.