Novel use of negative pressure ventilation for weaning of venovenous extracorporeal membrane oxygenation.
Adam Green, Sandhya Ashokkumar, Nafisa Wadud et al.
✦ AI-curated · Sources linked
Case in brief
A 40-year-old woman with ARDS caused by bacteremia and native mitral valve endocarditis developed refractory hypoxemia, with a PaO₂/FiO₂ ratio of 58, and was placed on venovenous ECMO. After 108 days, she still required both ventilator and ECMO support. A negative-pressure Cuirass device was added to positive-pressure ventilation. The combined approach improved carbon dioxide clearance and ventilation/perfusion matching, facilitating ECMO decannulation.
What made this case unusual
Negative-pressure ventilation was used alongside positive-pressure ventilation specifically to assist weaning from prolonged venovenous ECMO, rather than as respiratory support alone.
Diagnostic / clinical pearl
In this case, adding Cuirass negative-pressure ventilation to positive-pressure ventilation improved gas exchange sufficiently to facilitate ECMO decannulation after prolonged support.
Why it matters
The report describes a potential adjunctive use of negative-pressure ventilation for a patient on prolonged ECMO support with no other options; it does not establish effectiveness beyond this case.