Parallel Venous Extracorporeal Membrane Oxygenation Circuits During Bridge-to-Lung Transplantation

Venovenous (VV) extracorporeal membrane oxygenation (ECMO) supports end-organ oxygen delivery in patients with refractory respiratory failure. Physical therapy (PT) while on ECMO provides conceptual benefits of strength and conditioning. Physical therapy can additionally be used to facilitate improvements in functional status of pulmonary reserve while VV ECMO is used to bridge to lung transplant or recovery. We report the case of a patient initially supported with VV ECMO that due to a course complicated by refractory hypoxia, cardiac arrest, and cardiogenic shock, was successfully supported with parallel, independent VV ECMO circuits, allowing for ongoing PT, to bridge to lung transplant, decannulation, and hospital discharge.