Active rehabilitation with venovenous extracorporeal membrane oxygenation as a bridge to lung transplantation in a pediatric patient

Don Hayes Jr, Patrick I McConnell, Thomas J Preston, Andrew R Yates, Stephen Kirkby, Mark Galantowicz

Columbus, Ohio, USA

Author Affiliations: Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH, USA (Hayes D Jr, Yates AR, Kirkby S); Department of Cardiothoracic Surgery, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH, USA (McConnell PI, Galantowicz M); Department of Cardiovascular Perfusion, The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA (Preston TJ)

Corresponding Author: Don Hayes Jr, MD, MS, The Ohio State University Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA (Tel: 614-722-3425; Fax: 614-722-3426; Email: hayes.705@osu.edu)

doi: 10.1007/s12519-013-0437-x

Background: Active physical rehabilitation while bridged to lung transplantation with venovenous (VV) extracorporeal membrane oxygenation (ECMO) is an evolving treatment option in adults with limited published experience in pediatric patients.

Methods: The administration of VV ECMO through the placement of a single-site bicaval dual-lumen (BCDL) catheter (Avalon Laboratories, Rancho Dominguez, CA, USA) permits respiratory support in a critically ill patient with avoidance of sedation and paralytics while allowing rehabilitation and oral nutrition.

Results: A 13-year-old girl with advanced interstitial lung disease underwent active rehabilitation while being bridged to lung transplantation with single-site VV ECMO.

Conclusions: The innovative use of single-site VV ECMO with a BCDL catheter is transforming the care of adult patients with advanced lung disease and acute respiratory failure as a method to extend the life of a lung transplantation candidate to maximize all opportunities for organ availability. Based on our experiences, clinicians caring for children should be aware of this potential option in pediatric patients requiring lung transplantation.

Key words: active rehabilitation; bridge; extracorporeal membrane oxygenation; lung transplantation; venovenous

World J Pediatr 2013;9(4):373-374