Open AccessLung Transplantation After 125 Days on ECMO for Severe Refractory Hypoxemia With No Prior Lung Disease
Author(s) -
Shameen Salam,
Robert M. Kotloff,
Puneet Garcha,
Sudhir Krishnan,
Dhruv Joshi,
Patrick Grady,
Abhijit Duggal
Publication year - 2017
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0000000000000450
Subject(s) - ards , medicine , extracorporeal membrane oxygenation , hypoxemia , lung transplantation , refractory (planetary science) , intensive care medicine , lung , transplantation , intensive care unit , surgery , anesthesia , physics , astrobiology
Venovenous extracorporeal membrane oxygenation (ECMO) has become a viable and increasingly utilized option for the treatment of refractory hypoxemia in severe acute respiratory distress syndrome (ARDS). However, options are limited for ARDS patients who fail to wean from ECMO. The high rates of infection, presence of extrapulmonary end organ damage, intensive care unit-acquired weakness, and high short-term mortality associated with ARDS are all significant hurdles that make lung transplantation a difficult prospect to consider. However, ECMO support has been used as a bridge to transplant in patients with other underlying chronic lung diseases. Our case illustrates the successful use of lung transplantation for a patient with no previous lung disease who developed refractory ARDS requiring protracted ECMO support. The use of ambulatory ECMO with early institution of physical therapy is an essential component in preparing such patients for successful transplantation.