Veno-venous extracorporeal membrane oxygenation (VV-ECMO) has been indicated in patients with severe refractory respiratory failure from various causes for more than 30 years, even for the small infant.1 Improved outcome from using ECMO for respiratory failure has been reported worldwide, ranging from 15% to over 50% in recent reviews.1,2 The rationale of this therapy is to allow time for the lungs to heal, minimizing further lung injury from positive pressure ventilation.3,4 We describe a case of severe acute respiratory distress syndrome (ARDS) with extensive barotrauma supported by VV-ECMO for 96 days in a resource-limited center. This is likely the longest ECMO support ever reported in a child.
VasavadaRFengQUndarA. Current status of pediatric/neonatal ECMO: clinical outcomes, circuit evolution and translation research. Perfusion2011; 26: 294–301.
2.
ZabrockiLBroganTStatlerK. ECMO for pediatric respiratory failure: survival and predictors of mortality. Crit Care Med2011; 39: 364–370.
3.
BeiderlindenMEikermannMBoesT. Treatment of severe acute respiratory distress syndrome: role of extracorporeal exchange. Intensive Care Med2006; 32: 1627–1631.
4.
TiruvoipatiRBothaJPeekG. Effectiveness of ECMO when conventional ventilation fails: valuable option or vague remedy?J Crit Care2012; 27: 153–158.
5.
DiazJBrowerRCalfeeC. Therapeutic strategies for severe acute lung injuries. Crit Care Med2010; 38: 1644–1650.
6.
ZulianFToledoMAmigoniA. Successful use of ECMO for severe interstitial lung disease in a child with dermatomyositis. Intensive Care Med2007; 33: 1663–1666.
7.
IaconoAGarciaJGriffithB.Lung transplantation following 107 days of ECMO. Eur J Cardiothorc Surg2010; 37: 969–971.
8.
ThiaraAHaylandVNorumH. ECMO support for 59 days without changing the ECMO circuit: a case of Legionella Pneumonia. Perfusion2009; 24: 45–47.
9.
CamboniDPhilippALubnowM. Support time-dependent outcome analysis for veno-venous ECMO. Eur J Cardiothorc Surg2011; 40: 1341–1346: discussion 1346–1347.
