Postoperative Management of Respiratory Failure: Extracorporeal Ventilatory Therapy

Post-thoracotomy acute lung injury is one of the leading causes of mortality after thoracic surgery. Several trigger factors have been identified such as preoperative conditions, surgery-associated inflammation, fluid overload, ventilator-induced lung injury, one-lung ventilation, as well as transfusions. In severe cases the clinical presentation is an acute respiratory distress syndrome in adult patients with a high mortality rate. In the last decade, the concept of lung-“protective” ventilation strategies has been gaining importance in thoracic surgery. However, in a case of severe post-thoracotomy acute lung injury refractory to maximal conservative treatment, the use of extracorporeal ventilatory therapy might be indicated representing the concept of “lung rest.”.