Successful use of veno‐venous extracorporeal membrane oxygenation for acute chest syndrome in a child with sickle cell disease and SARS‐CoV‐2

• Published in: Pediatric pulmonology 2022-04, Vol.57 (4), p.1096-1099
• Main Authors: Koh, Wonshill, Malik, Punam, Whitehead, Jason, Morales, David Luis Simon, Hayes, Don
• Format: Article
• Language: English
• Subjects: acute chest syndrome; Acute Chest Syndrome - complications; Acute Chest Syndrome - therapy; acute respiratory distress syndrome; Anemia, Sickle Cell - complications; Anemia, Sickle Cell - therapy; Child; COVID-19 - complications; COVID-19 - therapy; Extracorporeal membrane oxygenation; Extracorporeal Membrane Oxygenation - adverse effects; Humans; Infections; lung transplant; Male; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Sickle cell disease
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.25843

Children with sickle cell disease (SCD) are at increased risk for severe illness due to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). We describe the successful native lung recovery of a child with SCD referred for lung transplant (LTx) evaluation who was on prolonged veno‐venous extracorporeal membrane oxygenation (VV‐ECMO). He initially presented with acute chest syndrome complicated by SARS‐CoV‐2 infection that ultimately required dual‐lumen, single bicaval VV‐ECMO cannulation for respiratory support. Despite the increased risk of hemolysis and thrombosis from SCD and SARS‐CoV‐2 infection, he was successfully supported on VV‐ECMO for 71 days without complications leading to native lung recovery with meticulous management of his SCD therapy. This report provides new insight on our approach to VV‐ECMO support in a child with SCD and SARS‐CoV‐2 infection. With a successful outcome, the patient has returned home but still on mechanical ventilation with LTx still an option if he is not eventually liberated from invasive respiratory support.