Extracorporeal membrane oxygenation for hydrocarbon aspiration

Extracorporeal membrane oxygenation (ECMO) is a technique of oxygenating the blood using an artificial membrane located outside of the body; it is used to treat infants with severe lung disease. Although the technique is associated with a high rate of complications and death, it has been used to maintain children who are at great risk from respiratory damage. The present report concerns two case studies of children who breathed in toxic levels of petroleum household products. One child was a 15-month-old male who aspirated baby oil. When seen at the hospital he respiration was poor and chest X-rays showed his lungs to be abnormal. He received oxygen (50 percent) via a mask, but despite these measures his condition continued to deteriorate. He developed a pneumothorax (air in the chest cavity), which further depressed lung function, and had to undergo an operation to drain his chest of air. He recovered, only to develop a fever; blood cultures were performed and he was given an antibiotic. A second pneumothorax developed on the opposite side of the first, necessitating another draining procedure. His respiratory condition continued to decline, and he was placed on ECMO, which maintained him for nearly one month, but not without difficulties, including repeat infections and neurologic damage. A second patient, a 16-month-old male, was admitted after aspirating furniture polish. His condition deteriorated and he was placed on ECMO using modifications of technique that were developed from experience with the first child. During his seven days on ECMO he underwent a course of antibiotic treatment. The patient was seen for follow-up several months after his discharge and both his respiratory status and neurologic condition were normal. It is important to realize that ECMO is not curative, but allows oxygenation of the body to occur while the lungs are allowed to rest and recover from insult. All liquid hydrocarbons pose risk to the lungs of small children if inhaled or ingested. (Consumer Summary produced by Reliance Medical Information, Inc.)