Author/Authors :
Tissot، Cecile نويسنده Department of the Child and Adolescent, Children’s University Hospital of Geneva, Geneva, Switzerland , , Habre، Walid نويسنده Department of the Child and Adolescent, Children’s University Hospital of Geneva, Geneva, Switzerland , , Soccal، Paola نويسنده Division of Pneumology, University Hospital of Geneva, Geneva, Switzerland , , Hug، Maja Isabel نويسنده Institute of Anesthesiology, University Hospital of Zurich, Zurich, Switzerland , , Bettex، Dominique نويسنده Institute of Anesthesiology, University Hospital of Zurich, Zurich, Switzerland , , Pellegrini، Michel نويسنده Department of the Child and Adolescent, Children’s University Hospital of Geneva, Geneva, Switzerland , , Aggoun، Yacine نويسنده Department of the Child and Adolescent, Children’s University Hospital of Geneva, Geneva, Switzerland , , Mornand، Anne نويسنده Department of the Child and Adolescent, Children’s University Hospital of Geneva, Geneva, Switzerland , , Kalangos، Afksendyios نويسنده Department of the Child and Adolescent, Children’s University Hospital of Geneva, Geneva, Switzerland , , Rimensberger، Peter نويسنده Department of the Child and Adolescent, Children’s University Hospital of Geneva, Geneva, Switzerland , , Beghetti، Maurice نويسنده ,
Abstract :
The use of extracorporeal membrane oxygenation (ECMO) is considered a risk factor for, or even a potential contraindication to, lung transplantation. However, only a few pediatric cases have been described thus far. A 9-year-old boy with idiopathic pulmonary arterial hypertension developed cardiac arrest after the insertion of a central catheter. ECMO was used as a bridge to lung transplantation. However, after prolonged resuscitation, he developed medullary ischemia and medullary syndrome. After 6 weeks of ECMO and triple combination therapy for pulmonary hypertension, including continuous intravenous prostacyclin, he was weaned off support, and after 2 weeks, bilateral lung transplantation was performed. At 4 years post-transplant, he has minimal problems. The medullary syndrome has also alleviated. He is now back to school and can walk with aids. Increasing evidence supports the use of ECMO as a bridge to LT, reporting good outcomes. In the modern era of PAH therapy, it is feasible to use prolonged ECMO support as a bridge to lung transplant, with the aim of weaning off this support; however, its use requires more experience and knowledge of long-term outcomes.
