A 22 Year Old Female Case Scenario: Veno-venous Extracorporeal Membrane Oxygenation

Abstract

ECMO (Extracorporeal membrane oxygenation) is one of the epic innovations of medical science to support the life of a human, in various conditions of lung failure, where it is difficult to maintain oxygenation of the body. ECMO was considered a very good option for conventional cardiopulmonary bypass technique and evolved into treatment of severe acute respiratory distress syndrome (ARDS) during the 1970s. Many kinds of research have been done on a similar topic. The initial reports on the utilisation of ECMO in ARDS patients were very exciting, and afterwards, ECMO proved to be certainly advantageous in infants having acute respiratory failure with a survival rate of almost 80%. There were two large randomised controlled trials, done during the period of 1979-1994 in adults with ARDS, that showed the failure of ECMO, with the survival rate range between 10% to 33%in the ECMO groups. Since then, ECMO treatment for ARDS patients has undergone further advancements by combining with lung-protective ventilation strategies and further by applying heparin-coated equipment, membranes, and tubings. Many healthcare facilities have used this advanced ECMO technology and achieved survival rates of more than 50%. However, whether improved ECMO can really challenge the advanced conventional treatment of adult ARDS is still a matter of debate and needs further studies.It was seen that acute respiratory failure requires intensive care. In few cases where ventilator support doesn’t prove effective, only the option of V-V ECMO remains. The present article describes the case of a 22-year-old female patient who was admitted with severe acute respiratory distress syndrome with associated multiple organ failure. The patient was admitted to the emergency of the Fortis Hospital with suspected acute kidney injury of unknown aetiology. After the initial 4 days of diagnostics at the ward, the patient required a further 24 days of hospital treatment and spent 16 days at the Intensive Care Unit. There, she underwent ECMO V-V therapy, lasting 14 days, which resulted initially in the improvement of his arterial blood gas parameters and clinical condition but later on, she developed pneumothorax and her condition worsened day by day gradually becoming critical.