Right Ventricular Failure in a Patient Supported with VV-ECMO: Implications and Therapeutic Strategies

Abstract

A 46-year-old woman was admitted to the intensive care unit with severe acute respiratory distress syndrome (ARDS) due to Legionella pneumonia. Refractory hypoxemia developed despite conventional lung-protective mechanical ventilation and the patient was managed with veno-venous extracorporeal membrane oxygenation. Subsequent right ventricular (RV) failure developed and was successfully treated with a percutaneously inserted right ventricular assist device attached to an oxygenator. This report discusses the pathophysiology, diagnosis, and treatment of RV failure as a complication of ARDS in the context of the current literature and provides a rationale for the use of mechanical circulatory support devices in this setting.