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Acute lung failure during mechanical circulatory support
Ulrich Schweigmann1, Birgit Schwarz, Corinna Velik-Salchner
1Department of Pediatrics, Division of Pediatrics III, Cardiology, Pulmonary, Allergology, and Cystic Fibrosis, Medical University Innsbruck, Austria.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|September 25, 2008
Summary
Venoarterial extracorporeal membrane oxygenation and ventricular assist devices are established for pediatric heart failure. A bridge-to-bridge strategy improves survival, and a novel case shows successful venovenous extracorporeal membrane oxygenation in an adolescent with acute respiratory failure on ventricular assist device support.
Area of Science:
- Pediatric Cardiology
- Cardiopulmonary Support
- Critical Care Medicine
Background:
- Venoarterial extracorporeal membrane oxygenation (VA-ECMO) and ventricular assist devices (VADs) are established treatments for pediatric end-stage heart failure.
- Bridge-to-bridge strategies utilizing these devices demonstrate excellent survival rates in pediatric patients.
Observation:
- This case report details an adolescent experiencing acute respiratory failure.
- The respiratory failure was potentially linked to transfusion-related lung injury.
- The patient was already supported by a ventricular assist device.
Findings:
- Successful treatment was achieved using venovenous extracorporeal membrane oxygenation (VV-ECMO).
- This occurred concurrently with ongoing ventricular assist device support.
- This represents a novel application of combined mechanical circulatory support.
Implications:
- This case highlights the potential efficacy of VV-ECMO in conjunction with VADs for managing complex respiratory failure in pediatric patients.
- It expands the therapeutic options for critically ill children with combined cardiac and pulmonary compromise.
- Further research into combined VV-ECMO and VAD strategies may be warranted for similar complex cases.
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