Pediatr Emerg Med J.  2024 Apr;11(2):91-97. 10.22470/pemj.2023.00878.

Two cases of extracorporeal membrane oxygenation for ventilator-dependent infants with bronchopulmonary dysplasia and pulmonary hypertension

• Jeon YH
• Jang W
• Kwon HW
• Cho S
• Kwak JG
• Lee IK
• Lee KH
• Park JD
• Lee B

• KMID: 2554082
• DOI: http://doi.org/10.22470/pemj.2023.00878

Abstract

Bronchopulmonary dysplasia (BPD) and pulmonary hypertension (PH) are potentially fatal complications in prematurely born infants. Extracorporeal membrane oxygenation (ECMO) may be a life-saving option for managing infants with BPD and PH. We present 2 patients who were successfully weaned off mechanical ventilators (MVs) through the application of ECMO. The patients were transferred to our institution after receiving MV care for 8 and 10 months, respectively, for BPD and PH. We were able to remove the patients from MVs after a period of ECMO-mediated lung rest. Although more research is required to determine specific criteria for ECMO use in patients with BPD and PH, our clinical experiences may contribute to the early application of ECMO in MV-dependent patients.

Keyword

Bronchopulmonary Dysplasia; Extracorporeal Membrane Oxygenation; Hypertension, Pulmonary; Infant, Premature; Intensive Care Units, Pediatric

Figure

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  Fig. 1. Serial chest radiographs of patient 1. (A) The radiograph shows multiple atelectases, chiefly in the right upper lung, and cystic lesions with an endotracheal tube (arrowhead), left internal jugular central venous catheter (arrow), and nasojejunal tube (asterisk) inserted (day 1, hospitalized to the pediatric intensive care unit). (B) It shows hyperinflated right lung and collapsed left lung with a double-lumen catheter (arrowhead) for venovenous ECMO in the early stage of ECMO use (day 7). (C) It shows similarly inflated lungs, right after cessation of ECMO (day 43). (D) It is the most recent radiograph taken at the outpatient clinic (day 495). ECMO: extracorporeal membrane oxygenation.

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  Fig. 2. Serial chest radiographs of patient 2. (A) It shows extensive reticular opacity with patchy hyperinflated areas, with an endotracheal tube (arrowhead) and nasojejunal tube (asterisk) inserted (day 1). (B) It shows improved lung conditions 1 month after ECMO modulated lung resting, with a double-lumen catheter (arrowhead) and left internal jugular hemodialysis catheters (arrow) (day 58). (C) It shows hyperinflated lungs immediately after the removal of the double-lumen catheter (day 96). (D) It is the most recent radiograph taken at the outpatient clinic (day 476). ECMO: extracorporeal membrane oxygenation.

Reference

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