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Background: Refractory hypoxia and hypercapnia are a rare and severe dangerous complication of acute respiratory distress syndrome (ARDS) leading to mortality and morbidity.Venovenous extracorporeal membrane oxygenation (VV ECMO) is reported as one of the rescue treatments for this life-threatening hypoxia and hypercapnia.Case presentation: A 12-year-old boy with refractory ARDS managed with mechanical ventilation but complicated by bilateral pneumothorax and cardiac arrest.Venovenous extracorporeal membrane oxygenation was initiated because of severe hypoxia and hypercapnia due to his worst lung condition shifted to a lung transplant center on ECMO.The patient was weaned successfully on day 60th and discharged on the 90th day of admission without the need for lung transplantation.Conclusion: Venovenous extracorporeal membrane oxygenation can be considered for supportive therapy in refractory severe acute respiratory failure after failing all conventional measures.To get the best results, ECMO should be initiated as early as possible in refractory ARDS patients.
Gupta et al. (Wed,) studied this question.