Journal of the Formosan Medical Association
Volume 105, Issue 5 , Pages 422-426, 2006

Prolonged Extracorporeal Membrane Oxygenation Support for Acute Respiratory Distress Syndrome

  • Wen-Je Ko

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr. Wen-Je Ko, Department of Surgery, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei 100, Taiwan
    • ,
  • Hsao-Hsun Hsu
    • ,
  • Pi-Ru Tsai

Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan

Received 30 May 2005; received in revised form 1 July 2005; accepted 2 August 2005.

Article Outline

When all conventional treatments for respiratory failure in patients with acute respiratory distress syndrome (ARDS) have failed, extracorporeal membrane oxygenation (ECMO) can provide a chance of survival in these desperately ill patients. A 49-year-old male patient developed septic shock and progressive ARDS after liver abscess drainage. Venovenous ECMO was given due to refractory respiratory failure on postoperative day 6. Initially, two heparin-binding hollow-fiber microporous membrane oxygenators in parallel were used in the ECMO circuit. Twenty-two oxygenators were changed in the first 22 days of ECMO support because of plasma leak in the oxygenators. Each oxygenator had an average life of 48 hours. Thereafter, a single silicone membrane oxygenator was used in the ECMO circuit, which did not require change during the remaining 596 hours of ECMO. The patient's tidal volume was only 90 mL in the nadir and less than 300 mL for 26 days during the ECMO course. The patient required ECMO support for 48 days and survived despite complications, including septic shock, ARDS, acute renal failure, drug-induced leukopenia, and multiple internal bleeding. This patient received an unusually long duration of ECMO support. However, he survived, recovered well, and was in New York Heart Association functional class I-II, with a forced expiratory volume in 1 second of 81% of the predicted level 18 months later. In conclusion, ECMO can provide a chance of survival for patients with refractory ARDS. The reversibility of lung function is possible in ARDS patients regardless of the severity of lung dysfunction at the time of treatment.

Key Words:  acute respiratory distress syndrome , extracorporeal membrane oxygenation , multiple organ failure

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PII: S0929-6646(09)60140-6

doi:10.1016/S0929-6646(09)60140-6

Journal of the Formosan Medical Association
Volume 105, Issue 5 , Pages 422-426, 2006

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