Extracorporeal Membrane Oxygenation in a case of opioid-induced acute respiratory distress syndrome

Introduction: Currently Extracorporeal Membrane Oxygenation (ECMO) is used for long-term support of respiratory and/or cardiac function, ECMO is primarily indicated for patients with temporary severe ventilation and/or oxygenation problems that they are unlikely to survive conventional lung protective mechanical ventilation. Aim of the work: We describe our experience in the management of a case of opioid-induced acute respiratory distress syndrome with ECMO. Methods: A 22 year old female, known Heroin addict, admitted with severe ARDS, failed to improve with conventional ventilation, Murray Lung Injury Score was 3.5, RESP score (8) was 4, underwent Veno-venous (V-V) ECMO via femoro-atrial approach using Maquet Cardiohelp console. The ECMO run duration was 12 days. Successful decannulation was done after weaning off ECMO by decreasing FiO2 on ECMO, and continuing mechanical ventilation on pressure support ventilation. Results: Successful weaning of ECMO on day 12 and successful extubation on day 14. Conclusion: ECMO can be used safely and successfully in the treatment of Heroin induced ARDS

One hundred forty six days on extracorporeal membrane oxygenation (ECMO): Our longest ECMO run

Introduction: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) provides the respiratory support in acute severe respiratory failure until the underlying acute lung pathology improves. VV-ECMO support for. Aim of the work: We describe our experience in the management of the longest ECMO run in our center. Methods: A 17 years old Male patient who had only vague past medical history of recurrent abdominal pain for 5 years. Patient was admitted with severe ARDS that failed to improve with conventional ventilation, Murray Lung Injury Score was 3.5, RESP score was 1, underwent Veno-venous (V-V) ECMO via femoro-atrial approach using Maquet Cardio help console. The ECMO run duration was 146 days. Patient suffered from several complications during the ECMO run such as pulmonary hemorrhage, Acute cor pulmonale, thrombocytopenia and convulsions. Results: Patient expired on ECMO day 146 with refractory septic shock even after shifting to VAV ECMO support. Conclusion: Prolonged ECMO therapy poses its unique challenges. Multidisciplinary team management plays fundamental role during management of prolonged ECMO therapy. Keywords: ARDS, ECMO, Shock, Thrombocytopenia, Cor pulmonal