Use of extracorporeal membrane oxygenation to rescue a child with acute respiratory distress syndrome

Acute respiratory distress syndrome (ARDS) carries a high mortality of abou t 60%. The results of conventional treatments for ARDS are poor. We report the use of extracorporeal membrane oxygenation (ECMO) to rescue a child wit h ARDS. The patient, a 7-year-old boy, underwent a Ross procedure and mitra l valvuloplasty because of severe aortic and mild mitral regurgitation.;ARD S due to massive transfusion and prolonged cardiopulmonary by-pass develope d in the early postoperative period. Hypoxemia persisted despite convention al treatments, including pressure-controlled ventilation and high-frequency ventilation. Finally, venovenous ECMO was used to rescue the patient. With ECMO support, gas exchange was well maintained with a lower ventilator set ting, and ventilator-induced Lung injuries were avoided. ECMO was used for 183 hours, at which point the boy was weaned without complications. His rec overy was uneventful. At the latest followup, 6 months after the operation, he was in New York Heart Association function class I and had no complaint s of lung disease. This case suggests that venovenous ECMO can be a rescue method for patients with ARDS that is refractory to conventional treatments .