Application of extracorporeal membrane oxygenation for respiratory failure following septic pulmonary emboli

A 23-year-old man, diagnosed as ventricular septal defect in childhood, was hospitalized with right-sided infective endocarditis. He developed acute respiratory failure following septic pulmonary emboli and underwent urgent surgical treatment, because vigorous medical treatment was ineffective. Extracorporeal membrane oxygenation was performed to maintain arterial blood oxygen tension after cardiopulmonary bypass and the patient was weaned from ECMO after 36 hours. Postoperatively, mechanical ventilation for respiratory failure was needed continuously and pleural leaks due to lung injuries were increased. The reduction of pleural leaks by surgical closure of fistula and plication of the cyst decreased gas exchange impairment. To our knowledge, application of extracorporeal membrane oxygenation for septic pulmonary emboli is unprecedented.