Case Report

Lung Reperfusion Injury after Congenital Cardiac Surgery in Pediatric Patients: Comparing Outcomes with and without Veno-Arterial ECMO Support

Abstract

Lung reperfusion injury (LRI) is a rare but severe complication following pediatric cardiac surgery with cardiopulmonary bypass in patients with complex congenital heart disease. We report two cases of postoperative LRI with different clinical outcomes. The first patient, a 9-year-old female with tetralogy of Fallot, developed severe hypoxemic respiratory failure and ARDS on postoperative day 2 and recovered after timely veno-arterial extracorporeal membrane oxygenation (VA-ECMO). The second patient, a 14-month-old male with situs ambiguus, right isomerism, and double outlet right ventricle, progressed to ARDS and multiorgan failure despite maximal conventional therapy and died on postoperative day 10 without ECMO support. These cases emphasize the importance of early recognition of LRI and timely ECMO initiation in selected patients with refractory respiratory failure.

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SectionCase Report(s)
Keywords
lung reperfusion injury pediatric cardiac surgery ECMO acute respiratory distress syndrome tetralogy of Fallot double outlet right ventricle
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How to Cite
1.
Fitriana A, Perdhana F. Lung Reperfusion Injury after Congenital Cardiac Surgery in Pediatric Patients: Comparing Outcomes with and without Veno-Arterial ECMO Support. Arch Anesth & Crit Care. 2026;.