Case report demonstrates effective treatment of refractory hypoxemia in a child using mechanical ventilation and membraned oxygenation, suggesting a viable intervention.
A four-year-old boy manifested the signs of refractory hypoxemia secondary to the aspiration of gastric contents and the administration of 100 per cent oxygen for more than seven days. Because the hypoxemia did not improve with controlled oxygen therapy and mechanical ventilation with PEEP, partial cardiopulmonary bypass and membrane oxygenation was added to the mechanical ventilation with PEEP. With FIO2 0.70, the PaO2 rose to 228 mm Hg, and with FIO2 0.40, PaO2 was 194 mm Hg. The patient was kept alive and oxygenated for 33 hours with mechanical ventilation and extracorporeal membrane oxygenation.
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Bernhard et al. (1974) studied this question.
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