Use of single-cannula extracorporeal membrane oxygenation in the pulmonary artery to provide right heart support during respiratory failure in a drowning victim

Acute respiratory distress syndrome (ARDS) and respiratory failure can occur after drowning. Some of these patients do not respond to conventional mechanical ventilation and require extracorporeal membrane oxygenation (ECMO). Patients with severe respiratory failure can also develop acute right heart failure. We describe a case of a young drowning victim who developed ARDS and subsequent right heart failure. The patient was initiated on venovenous ECMO with right atrial to pulmonary artery cannulation of ECMO using the Protek Duo (TandemLife, Pittsburgh, PA, USA). The patient recovered from his ARDS and heart failure and was successfully liberated from ECMO. We will discuss the utility of ECMO in drowning victims and the use of this unique cannulation strategy to support the right ventricle in patients with concomitant respiratory failure.