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.

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Netherlands Journal of Critical Care
Department of Intensive Care

van Osch, D. (D.), Rozendaal, F., Bokhoven, K.C. (K. C.), Polad, J., dos Reis Miranda, D., & Polderman, F. (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