The long duration of extracorporeal membrane oxygenation in a child with acute severe hypoxic respiratory failure treated in a resource-limited center

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.