The use of venovenous extracorporeal membrane oxygenation (V-V ECMO) in adult patients with acute severe but potentially reversible respiratory failure remains controversial and it is recommended that V-V ECMO is restricted to a small number of specialised centres. We present a case in which initiating V-V ECMO in a large teaching hospital, complemented with mechanical circulatory support using an Impella® device, was lifesaving in a 55-year-old man with severe respiratory failure secondary to massive gastric aspiration and cardiogenic shock following cardiac arrest. V-V ECMO may be lifesaving in some well-selected patients with life-threatening hypoxaemia, even if the hypoxaemia is of combined cardiac and pulmonary origin. For additional circulatory support, Impella® might be a better choice than veno-arterial ECMO, because of avoiding an increase in left atrial pressure. In a rapidly deteriorating patient it may be necessary to initiate V-V ECMO immediately, outside an ECMO centre of expertise. In such situations, it is of paramount importance to have a close collaboration with an ECMO centre of expertise.

Case report, Therapy refractory respiratory failure, Venovenous extracorporeal membrane oxygenation
Netherlands Journal of Critical Care
Department of Intensive Care

van Osch, D. (D.), Rozendaal, F.W, Bokhoven, K.C. (K. C.), Polad, J, dos Reis Miranda, D, & Polderman, F.N. (2020). The use of venovenous extracorporeal membrane oxygenation outside a centre of expertise: A case report. Netherlands Journal of Critical Care, 28(4), 170–174. Retrieved from