Rapid Treatment With Veno-Venous Extracorporeal Membrane Oxygenation in a Patient Who Developed Acute Respiratory Distress Syndrome After Drowning

This is a case of a 76-year-old male with a past medical history of hypertension, chronic kidney disease (CKD), transient ischemic attack (TIA) status post tissue plasminogen activator (tPA), bilateral carotid stenosis, and seizure disorder who was brought into a South Florida emergency department by emergency medical services after a drowning incident secondary to a seizure. It was found that he had low oxygen saturation, a low Glasgow coma score (GCS), and was intubated and mechanically ventilated. CT of the chest and arterial blood gas (ABG) determined that he had acute respiratory distress syndrome (ARDS) with severe hypoxemia despite mechanical ventilation. The patient was started on venovenous extracorporeal membrane oxygenation (V-V ECMO) within hours of being brought in by EMS and was successfully weaned from ECMO on day three. The patient eventually tolerated room air by day seven. This report highlights the importance of early initiation of ECMO in cases of ARDS. More studies are needed to determine if using ECMO after drowning can be used more commonly in practice, as in infectious cases.