Ambulatory ECMO as a Bridge to Lung Transplant in a Previously Well Pediatric Patient With ARDS

Author:

Turner David A.1,Rehder Kyle J.1,Bonadonna Desiree23,Gray Alice4,Lin Shu567,Zaas David4,Cheifetz Ira M.13

Affiliation:

1. Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children’s Hospital, Durham, North Carolina; and

2. Departments of Perfusion Services,

3. Respiratory Care Services,

4. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, and

5. Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina

6. Immunology, and

7. Pathology,

Abstract

Extracorporeal membrane oxygenation (ECMO) is increasingly implemented in patients with end-stage pulmonary disease as a bridge to lung transplant. Several centers have instituted an approach that involves physical rehabilitation and ambulation for patients supported with ECMO. Recent reports describe the successful use of ambulatory ECMO in patients with chronic respiratory illnesses being bridged to lung transplant. We describe the first case of a previously healthy pediatric patient with acute respiratory failure successfully supported with ambulatory ECMO as a bridge to lung transplant after an unsuccessful bridge to recovery. Although there are challenges associated with awake and ambulatory ECMO in children, this strategy represents an exciting breakthrough and a potential paradigm shift in ECMO management for pediatric acute respiratory failure.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

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