VV-ECMO as a lifesaving measure for refractory bronchospasm in anaphylactic shock: A case report.
Juan P Garcia-Mendez, Troy G Seelhammer, Patrick M Wieruszewski et al.
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Case in brief
A 32-year-old individual developed food-induced anaphylaxis with profound bronchospasm and respiratory failure. The bronchospasm did not respond to first- or second-line therapies, and severe hypoxemia and hypercapnia persisted despite mechanical ventilation. Peripheral venovenous extracorporeal membrane oxygenation (VV-ECMO) was initiated emergently. The patient stabilized rapidly and made a full recovery.
What made this case unusual
VV-ECMO was used as rescue support for anaphylaxis-induced bronchospasm refractory to standard therapies and mechanical ventilation, an uncommon application described in only a few reported cases.
Diagnostic / clinical pearl
In severe anaphylaxis, bronchospasm may cause hypoxemic and hypercapnic respiratory failure that persists despite mechanical ventilation; this case describes VV-ECMO as a bridge to stabilization.