Low flow veno-venous ECMO via subclavian dialysis catheter for severe respiratory failure.

BACKGROUND: We present the case of a 12-year-old female with severe postoperative bacterial pneumonia unresponsive to conventional treatment following a failed renal transplant.

CASE REPORT: The patient was placed on low flow veno-venous extracorporeal membrane oxygenation (ECMO) as an adjuvant treatment to antibiotic therapy and maximal ventilatory support. Venous ECMO resulted in rapid improvement and the patient was successfully weaned after 48 hours of circulatory assistance. Two days later, the patient was extubated and safely discharged from the intensive care unit. Eighteen months later, she remains stable on peritoneal dialysis and is awaiting a new donor kidney.

CONCLUSIONS: Low flow veno-venous ECMO represents a new therapeutic alternative for critically ill patients whose condition does not meet the conventional ECMO criteria. Further clinical experience is still needed.