title: Veno-Venous Extracorporeal Membrane Oxygenation Use in the Treatment of Bleomycin Pulmonary Toxicity.
abstract: Pulmonary toxicity is a devastating complication of bleomycin chemotherapy. This insult is likely exacerbated by the free radical injury induced by high inspired oxygen content, which is required to support these patients. Traditional treatment consists of high-dose corticosteroids. We report the case of a 45-year-old man who developed bleomycin pulmonary toxicity, which failed to respond to treatment with high-dose corticosteroids. We used protective mechanical ventilatory settings while supported on veno-venous extracorporeal membrane oxygenation using a bicaval dual-lumen, single cannula system to allow for lung recovery. This case demonstrates the feasibility of using veno-venous extracorporeal membrane oxygenation to treat bleomycin pulmonary toxicity in a patient who has failed traditional therapy.
authors.affiliation: From the *Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD USA; †Department of Cardiothoracic Surgery, University of Washington Seattle, Seattle, WA USA; and ‡Department of Cardiothoracic Surgery, Hahnemann University Hospital, Philadelphia, PA USA.
authors.forename: Aakash
authors.initials: A
authors.lastname: Shah
authors.forename: Chetan
authors.initials: C
authors.lastname: Pasrija
authors.forename: Anthony
authors.initials: A
authors.lastname: Kronfli
authors.forename: Brody
authors.initials: B
authors.lastname: Wehman
authors.forename: Bartley P
authors.initials: BP
authors.lastname: Griffith
authors.forename: Pablo G
authors.initials: PG
authors.lastname: Sanchez
authors.forename: Jose P
authors.initials: JP
authors.lastname: Garcia
authors.forename: Zachary N
authors.initials: ZN
authors.lastname: Kon
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001761:Bleomycin / Q000633:toxicity*; D003131:Combined Modality Therapy; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D055370:Lung Injury / Q000139:chemically induced / Q000188:drug therapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013736:Testicular Neoplasms / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D001761:Bleomycin