title: Ambulatory ECMO as a bridge to lung transplant in a previously well pediatric patient with ARDS.
abstract: Extracorporeal membrane oxygenation (ECMO) is increasingly implemented in patients with end-stage pulmonary disease as a bridge to lung transplant. Several centers have instituted an approach that involves physical rehabilitation and ambulation for patients supported with ECMO. Recent reports describe the successful use of ambulatory ECMO in patients with chronic respiratory illnesses being bridged to lung transplant. We describe the first case of a previously healthy pediatric patient with acute respiratory failure successfully supported with ambulatory ECMO as a bridge to lung transplant after an unsuccessful bridge to recovery. Although there are challenges associated with awake and ambulatory ECMO in children, this strategy represents an exciting breakthrough and a potential paradigm shift in ECMO management for pediatric acute respiratory failure.
authors: Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina; and david.turner@duke.edu.
authors: David A
authors: DA
authors: Turner
authors: Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina; and.
authors: Kyle J
authors: KJ
authors: Rehder
authors: Departments of Perfusion Services,Respiratory Care Services.
authors: Desiree
authors: D
authors: Bonadonna
authors: Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, and.
authors: Alice
authors: A
authors: Gray
authors: Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North CarolinaImmunology, andPathology.
authors: Shu
authors: S
authors: Lin
authors: Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, and.
authors: David
authors: D
authors: Zaas
authors: Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina; andRespiratory Care Services.
authors: Ira M
authors: IM
authors: Cheifetz
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D016040:Lung Transplantation; D011859:Radiography; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D014139:Tracheostomy
keywords: acute lung injury; acute respiratory distress syndrome; air leak; ambulation; extracorporeal membrane oxygenation; lung transplant; pediatric; physical therapy; pneumothorax; rehabilitation; respiratory failure