Extracorporeal membrane oxygenation support in individuals with thoracic insufficiency

Perfusion. 2018 Nov;33(8):696-698. doi: 10.1177/0267659118778173. Epub 2018 May 23.

Abstract

Introduction: Respiratory failure is the leading cause of mortality in individuals with congenital spine and rib deformities. We present a case report of a child with Jeune syndrome surviving respiratory failure using extracorporeal membrane oxygenation (ECMO). We also summarize thoracic insufficiency syndrome cases reported in the Extracorporeal Life Support Organization (ELSO) registry.

Case report: A two-year-old male with a chest circumference less than a third percentile for age was admitted with influenza pneumonia developing a peak oxygenation index of 103.5. The child survived to baseline pulmonary function after nine days of venous-arterial ECMO support.

Discussion: The ELSO registry contained 27 individuals with a surrogate diagnosis of thoracic insufficiency (0.05%). There was no significant difference in survival to discharge for thoracic insufficiency patients (52%) compared to a previously healthy population supported with ECMO.

Conclusion: ECMO is safe and may be effective in supporting individuals with thoracic insufficiency.

Keywords: Jeune syndrome; extracorporeal membrane oxygenation; pediatrics; thoracic insufficiency; thoracic surgery.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Ellis-Van Creveld Syndrome / complications
  • Ellis-Van Creveld Syndrome / physiopathology
  • Ellis-Van Creveld Syndrome / therapy*
  • Extracorporeal Membrane Oxygenation*
  • Humans
  • Male
  • Registries
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / physiopathology
  • Respiratory Insufficiency / therapy*

Supplementary concepts

  • Jeune syndrome