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Case Reports
Refractory Hypoxemia on VV-ECMO: Repetition of a Structured Approach Is Paramount: A Case Report.
- Claire de Forcrand, Chris M Cassara, John T Dollerschell, Rafal Kopanczyk, and Micah T Long.
- From the Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
- A A Pract. 2023 May 1; 17 (5): e01677e01677.
AbstractVeno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly used to manage severe respiratory failure. Unfortunately, refractory hypoxemia often complicates VV-ECMO support. Both circuit- and patient-related etiologies can drive this, and a structured approach is necessary to diagnose and treat the condition. We present the case of a patient on VV-ECMO for acute respiratory distress syndrome who suffered from several distinct etiologies of refractory hypoxemia over a short timeframe. Frequent recalculation of cardiac output and oxygen delivery enabled early diagnosis and treatment of these conditions. We highlight the need for a structured and oft-repeated approach to this complex problem.Copyright © 2023 International Anesthesia Research Society.
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