title: Membrane Oxygenator Use With Biventricular Assist Device: Facilitation of Support and Lung Recovery.
abstract: We present the use of a low-resistance membrane oxygenator (Quadrox D, Maquet) in series with a pulsatile right ventricular assist device (Berlin Heart EXCOR, Berlin Heart) in a patient with biventricular support who required high-frequency oscillatory ventilation (HFOV), due to refractory acute respiratory distress syndrome associated with Cytomegalovirus pneumonia. The high mean airway pressure associated with the use of HFOV resulted in a significant negative impact on left ventricular assist device (LVAD) filling that led to a combined respiratory and metabolic acidosis and the need for vasopressor support. Oxygenator placement enabled transition to conventional ventilation and the discontinuation of vasopressor support. This case demonstrates the feasibility and safety of the use of this lung support system in patients requiring ventricular assist device (VAD) support.
authors.affiliation: 1 Department of Pediatrics, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.|2 Division of Pediatric Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Nelson-McMillan
authors.affiliation: 3 Division of Cardiology, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Ravekes
authors.affiliation: 3 Division of Cardiology, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: William R
authors.initials: WR
authors.lastname: Thompson
authors.affiliation: 2 Division of Pediatric Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Brown
authors.affiliation: 4 Division of Cardiothoracic Surgery, Department of Surgery, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Larry
authors.initials: L
authors.lastname: Wolff
authors.affiliation: 1 Department of Pediatrics, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.|2 Division of Pediatric Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Rajeev S
authors.initials: RS
authors.lastname: Wadia
authors.affiliation: 5 Department of Pharmacy, the Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: LeAnn M
authors.initials: LM
authors.lastname: McNamara
authors.affiliation: 1 Department of Pediatrics, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.|2 Division of Pediatric Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Donald H
authors.initials: DH
authors.lastname: Shaffner
authors.affiliation: 1 Department of Pediatrics, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.|2 Division of Pediatric Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Ivor D
authors.initials: ID
authors.lastname: Berkowitz
authors.affiliation: 4 Division of Cardiothoracic Surgery, Department of Surgery, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Marshall L
authors.initials: ML
authors.lastname: Jacobs
authors.affiliation: 4 Division of Cardiothoracic Surgery, Department of Surgery, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Luca A
authors.initials: LA
authors.lastname: Vricella
mesh_terms: D002648:Child; D015199:Extracorporeal Membrane Oxygenation; D017809:Fatal Outcome; D006333:Heart Failure / Q000175:diagnosis* / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D010107:Oxygenators, Membrane
keywords: circulatory assist devices; heart failure; pediatric; pulmonary vascular resistance/hypertension