Extracorporeal membrane oxygenation in the treatment of inhalation injuries

Smoke inhalation is a leading cause of death in burns patients. Conventional ventilation cannot always maintain adequate tissue oxygenation. Extracorporeal membrane oxygenation (ECMO) has rarely been used in the treatment of smoke inhalation injuries. ECMO is a proven therapy in severe neonatal respiratory failure and has also been used to good effect in the treatment of children and adults. We report the cases of two children who developed severe respiratory failure refractory to maximal ventilation, one case followed smoke inhalation alone, the other followed smoke inhalation and bums. Pre-ECMO PaO2/FIO2 ratios were 6.5 and 8 kPa, respectively. The patients were treated with veno-venous ECMO for 72 and 144 h, respectively. The use of ECMO respiratory failure due to smoke inhalation and thermal injury is discussed. (C) 1998 Elsevier Science Ltd for ISBI. All rights reserved.