{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T18:05:27Z","timestamp":1777917927567,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2013,3,8]],"date-time":"2013-03-08T00:00:00Z","timestamp":1362700800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Patients on extracorporeal membrane oxygenation (ECMO) are at risk from thoracic complications such as bleeding or pneumothorax, which may subsequently necessitate thoracic surgical intervention. We aimed to: 1) analyse the indication and nature of thoracic surgical intervention in these patients and 2) analyse the effect of a change in the ECMO circuit from roller pump to centrifugal pump on transfusion requirements pre and post thoracotomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively reviewed a prospectively collected database of 569 adults put on ECMO between 1995 and 2011. Patients undergoing thoracotomy were identified and outcomes were statistically analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Forty thoracotomies were performed in 18 patients [61% male, median age 31 (14-56) years, one bilateral procedure]. The indications for ECMO included: pneumonia 14\/18 (78%), trauma 2\/18 (11%) and other 2\/18 (11%). Median duration on ECMO was 13 (1\u2013257) days and the time to initial thoracotomy was 10 (1-183) days. The indications for thoracotomy were: excessive bleeding post chest drain insertion (11\/19, 58%), uncontrolled air leak (9\/19, 47%) and pleural effusion (4\/19, 21%). The primary operations were 12\/19 (63%) evacuation of haemothorax, 3\/19 (16%) lung repair, 2\/19 (11%) diagnostic lung biopsy and 2\/19 (11%) other. Ten patients needed a further 21 thoracotomies (3 lobectomies); average 2 (1-5) per patient. In total, 30\/40 (75%) thoracotomies were performed for bleeding complication. The change from roller to centrifugal pump trended towards a reduction in mean transfusion requirements in these patients following thoracotomy (11.5 versus 4 units, p=0.14). The in-hospital mortality was 7\/18 (39%) patients. There were no statistically significant predictors of poor outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The need for thoracotomy whilst on ECMO is 3.2% in this large series. Intervention may be complicated, thus, either ECMO specialists should have thoracic training or thoracic surgeons should be on-site. Potential mortality is high and, although not statistically significant, a difference in transfusion requirements was observed following the change of circuit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0267659113480401","type":"journal-article","created":{"date-parts":[[2013,3,8]],"date-time":"2013-03-08T22:55:57Z","timestamp":1362783357000},"page":"328-332","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["The need for thoracic surgery in adult patients receiving extracorporeal membrane oxygenation: a 16-year experience"],"prefix":"10.1177","volume":"28","author":[{"given":"V","family":"Joshi","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Extracorporeal Membrane Oxygenation, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Nakas","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"DA","family":"Waller","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"GJ","family":"Peek","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Glenfield Hospital, Leicester, UK"},{"name":"Department of Extracorporeal Membrane Oxygenation, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Firmin","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Glenfield Hospital, Leicester, UK"},{"name":"Department of Extracorporeal Membrane Oxygenation, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,3,8]]},"reference":[{"key":"bibr1-0267659113480401","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-2512"},{"key":"bibr2-0267659113480401","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61069-2"},{"key":"bibr3-0267659113480401","unstructured":"Expansion of adult respiratory ECMO service. http:\/\/www.specialisedservices.nhs.uk\/news\/view\/expansion-adult-respiratory-ecmo-service. 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