SUCCESSFUL USE OF EXTRACORPOREAL MEMBRANE-OXYGENATION IN THE TREATMENT OF ACUTE CHEST SYNDROME IN A CHILD WITH SEVERE SICKLE-CELL-ANEMIA

Extracorporeal membrane oxygenation (ECMO) is widely used in the treat ment of respiratory and cardiovascular failure in neonatal patients. T he authors present a case of a child with hemoglobin SS disease who wa s treated with ECMO after acute chest syndrome and acute respiratory d istress syndrome developed. They also present data from the Extracorpo real Life Support Organization on this use of ECMO from other centers. To date, there have been 15 pediatric patients with acute chest syndr ome treated with ECMO. Survival rate has been 26%. In selected patient s with severe disease, ECMO can provide support at a lower mean airway pressure, allow for aggressive pulmonary lavage, and maintain adequat e tissue oxygen delivery until the patient is more stable. Patients wh o might benefit include those with poor ventilation secondary to mucou s plugging and barotrauma. The best success with these patients might be anticipated from venoarterial ECMO. Patients with severe cardiac or neurologic deterioration may constitute a group less likely to surviv e.