ECMO combined with sequential oxygen therapy in drowning-induced ARDS: a case report

Area of Science:

• Critical Care Medicine
• Pulmonology
• Emergency Medicine

Background:

• Drowning incidents can precipitate severe cardiorespiratory compromise.
• Acute Respiratory Distress Syndrome (ARDS) and pneumothorax are critical complications of near-drowning.
• Refractory hypoxemia poses a significant challenge in managing drowning victims.

Observation:

• A 35-year-old male presented with cardiorespiratory arrest post-drowning.
• Initial management included mechanical ventilation and thoracostomy, but hypoxemia persisted.
• Veno-venous extracorporeal membrane oxygenation (V-V ECMO) was initiated due to refractory hypoxemia.

Findings:

• Dynamic adjustment of respiratory support, including sequential oxygen therapy, was crucial.
• Balancing oxygenation with minimizing ventilator-induced lung injury was key.
• Targeted antimicrobial therapy and intensive care facilitated clinical improvement.

Implications:

• This case demonstrates the successful integration of V-V ECMO and sequential oxygen therapy for drowning-associated ARDS.
• This combined approach offers a potential strategy for complex respiratory failures in drowning victims.
• Effective management requires a multidisciplinary approach addressing critical cardiorespiratory and pulmonary issues.