• Niyati N Gandhi, Mary E Hartman, Walter L Williford, Michelle A Peters, Ira M Cheifetz, and David A Turner.
• Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, NC, USA. niyati.gandhi@duke.edu
• Pediatr Crit Care Me. 2011 Nov 1;12(6):e398-401.

ObjectiveTo report the first successful use of extracorporeal membrane oxygenation for acute respiratory distress syndrome secondary to 2009 pH1N1 influenza A infection in a child status post the Fontan operation for hypoplastic left heart syndrome.DesignIndividual case report.SettingPediatric intensive care unit.PatientWe describe a 7-yr-old boy with a history of the Fontan operation for hypoplastic left heart syndrome admitted with acute respiratory distress syndrome secondary to 2009 pH1N1 influenza A infection.InterventionCannulation for venoarterial extracorporeal membrane oxygenation.Measurements And Main ResultsIn this patient with a history of complex congenital heart disease and repair, extracorporeal membrane oxygenation was a successful rescue therapy for refractory pH1N1-induced respiratory failure.ConclusionExtracorporeal membrane oxygenation can be successfully applied for refractory respiratory failure, even in the setting of significant underlying comorbidity. With emerging data to support the role of extracorporeal membrane oxygenation in improving mortality for refractory hypoxemia secondary to pH1N1, it is prudent to strongly consider the use of extracorporeal support in patients with underlying diseases or comorbidities that may have previously precluded them from being candidates for this therapy.

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