Advancements in diagnosis and treatment of lung adenocarcinoma patients under ECMO support: a case series and comprehensive literature review
Abstract This case series explores the use of veno-venous extracorporeal membrane oxygenation (VV ECMO) as a bridge to diagnosis and treatment in patients with suspected lung adenocarcinoma and severe respiratory failure refractory to conventional mechanical ventilation. We present three cases where...
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| Format: | Article |
| Language: | English |
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BMC
2025-03-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-025-03384-z |
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| author | Xinyi Luo Jie Zhang Jieyi Pan Lingbo Nong Yin Xi Xiaowen Xie Ya Wang Weiqun He Xiaobo Chen Changhao Zhong Haibo Zhang Xiaoqing Liu Chengzhi Zhou Yonghao Xu |
| author_facet | Xinyi Luo Jie Zhang Jieyi Pan Lingbo Nong Yin Xi Xiaowen Xie Ya Wang Weiqun He Xiaobo Chen Changhao Zhong Haibo Zhang Xiaoqing Liu Chengzhi Zhou Yonghao Xu |
| author_sort | Xinyi Luo |
| collection | DOAJ |
| description | Abstract This case series explores the use of veno-venous extracorporeal membrane oxygenation (VV ECMO) as a bridge to diagnosis and treatment in patients with suspected lung adenocarcinoma and severe respiratory failure refractory to conventional mechanical ventilation. We present three cases where ECMO support was initiated to facilitate further diagnostic evaluations, including lung biopsy and bronchoalveolar lavage fluid liquid biopsy, enabling the identification of actionable mutations and guiding targeted therapies. Two patients achieved significant clinical improvement and were successfully weaned from ECMO, while one patient experienced an unfavorable outcome due to a combination of uncontrolled tumor progression and hospital-acquired pneumonia. Our findings suggest that ECMO, traditionally considered a relative contraindication in advanced cancer, can be a valuable temporary support in carefully selected patients, allowing time for diagnosis and targeted treatment initiation. Furthermore, our experience highlights the feasibility and safety of performing lung biopsies under ECMO with appropriate anticoagulation management. This study emphasizes the importance of individualized decision-making and a multidisciplinary approach when considering ECMO for lung cancer patients, carefully weighing the risks of infection and disease progression to optimize patient outcomes. |
| format | Article |
| id | doaj-art-d67404f689324671a875527dfea35ca6 |
| institution | Kabale University |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-d67404f689324671a875527dfea35ca62025-08-20T03:41:43ZengBMCJournal of Cardiothoracic Surgery1749-80902025-03-012011910.1186/s13019-025-03384-zAdvancements in diagnosis and treatment of lung adenocarcinoma patients under ECMO support: a case series and comprehensive literature reviewXinyi Luo0Jie Zhang1Jieyi Pan2Lingbo Nong3Yin Xi4Xiaowen Xie5Ya Wang6Weiqun He7Xiaobo Chen8Changhao Zhong9Haibo Zhang10Xiaoqing Liu11Chengzhi Zhou12Yonghao Xu13Department of Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Pulmonary and Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Pulmonary and Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Pulmonary and Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseDepartment of Critical Care Medicine, State Key Lab of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory DiseaseAbstract This case series explores the use of veno-venous extracorporeal membrane oxygenation (VV ECMO) as a bridge to diagnosis and treatment in patients with suspected lung adenocarcinoma and severe respiratory failure refractory to conventional mechanical ventilation. We present three cases where ECMO support was initiated to facilitate further diagnostic evaluations, including lung biopsy and bronchoalveolar lavage fluid liquid biopsy, enabling the identification of actionable mutations and guiding targeted therapies. Two patients achieved significant clinical improvement and were successfully weaned from ECMO, while one patient experienced an unfavorable outcome due to a combination of uncontrolled tumor progression and hospital-acquired pneumonia. Our findings suggest that ECMO, traditionally considered a relative contraindication in advanced cancer, can be a valuable temporary support in carefully selected patients, allowing time for diagnosis and targeted treatment initiation. Furthermore, our experience highlights the feasibility and safety of performing lung biopsies under ECMO with appropriate anticoagulation management. This study emphasizes the importance of individualized decision-making and a multidisciplinary approach when considering ECMO for lung cancer patients, carefully weighing the risks of infection and disease progression to optimize patient outcomes.https://doi.org/10.1186/s13019-025-03384-zLung adenocarcinomaRespiratory failureECMOLung biopsyTargeted therapy |
| spellingShingle | Xinyi Luo Jie Zhang Jieyi Pan Lingbo Nong Yin Xi Xiaowen Xie Ya Wang Weiqun He Xiaobo Chen Changhao Zhong Haibo Zhang Xiaoqing Liu Chengzhi Zhou Yonghao Xu Advancements in diagnosis and treatment of lung adenocarcinoma patients under ECMO support: a case series and comprehensive literature review Journal of Cardiothoracic Surgery Lung adenocarcinoma Respiratory failure ECMO Lung biopsy Targeted therapy |
| title | Advancements in diagnosis and treatment of lung adenocarcinoma patients under ECMO support: a case series and comprehensive literature review |
| title_full | Advancements in diagnosis and treatment of lung adenocarcinoma patients under ECMO support: a case series and comprehensive literature review |
| title_fullStr | Advancements in diagnosis and treatment of lung adenocarcinoma patients under ECMO support: a case series and comprehensive literature review |
| title_full_unstemmed | Advancements in diagnosis and treatment of lung adenocarcinoma patients under ECMO support: a case series and comprehensive literature review |
| title_short | Advancements in diagnosis and treatment of lung adenocarcinoma patients under ECMO support: a case series and comprehensive literature review |
| title_sort | advancements in diagnosis and treatment of lung adenocarcinoma patients under ecmo support a case series and comprehensive literature review |
| topic | Lung adenocarcinoma Respiratory failure ECMO Lung biopsy Targeted therapy |
| url | https://doi.org/10.1186/s13019-025-03384-z |
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