Abstract

Emergency use of extracorporeal membrane oxygenation (ECMO) for cardiopulmonary failure is well documented. However, the use of ECMO for carbon monoxide (CO) poisoning is rare. We report a case of a patient with severe CO poisoning that initially manifested as stunned myocardium-induced acute pulmonary edema. The patient was severely hypoxemic and refractory to mechanical ventilation at 7 hours after hospitalization. We applied veno-arterial ECMO for rescue life support for 3 days. The patient had a dramatic full recovery without immediate neurologic sequelae for the 3-day period. Under ECMO support, PaO2 increased from 34.8 to 299.9 mmHg, and ventilator FiO2 decreased to 0.4 within 3 days. The patient's consciousness also improved, with the Glasgow Coma Scale (GCS) score increasing from 8 to 15. Although the standard treatment for CO poisoning remains controversial, an aggressive rescue strategy is warranted for concurrent cardiovascular collapse and acute respiratory failure after severe CO poisoning in order to reduce the mortality of a reversible etiology.

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