SUCCESSFUL UTILIZATION OF ECMO TO TREAT AN ADULT BURN PATIENT WITH ARDS

We present an interesting case of the first adult reported in the Unit ed States to suffer from thermal burns, adult respiratory distress syn drome (ARDS) and to be treated with extracorporeal membrane oxygenatio n (ECMO) who survived. Our patient is a 26 year old male who sustained thermal burns (12% TBSA) to his face and anterior trunk and bronoscop ically demonstrable inhalation injury. He was transported to ur region al burn center for burn would cae and ventilatory support. The patient was treated with silver sulfadiazine 1% to his wounds which healed pe r primam. Because of low oxygen saturation he required increasing FIO2 . The following parameters: FIO2 = 1, PEEP = 17, minute ventilation of 15.1 1, pea airway pressure of 45 and mean of 27, along with chest X- rays corroborated the severity of ARDs. The patient failed volume cont rol ventilation. A trial of pressure ventilation was attempted but the patient only reached O-2 saturation in the low 80s. At this point, th e decision was made to transfer the patient to a hospital capable of E CMO treatment. The patient was subsequently treated with veno-venous E MO. Six weeks later the patient was discharged from the hospital off a ll ventilatory support. (C) 1998 Elsevier Science Ltd for ISBI. All ri ghts reserved.