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<p>Severe type II respiratory failure and septic shock are life-threatening conditions that require immediate intervention. The role of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in these cases remains debated. This case series describes two patients with similar presentations—severe type II respiratory failure due to acute exacerbation of poorly controlled bronchial asthma and refractory septic shock. Both had a sequential organ failure assessment (SOFA) score of 15 and met the criteria for severe respiratory failure and acute respiratory distress syndrome (ARDS). Despite adequate fluid resuscitation and high-dose vasopressor and inotropic therapy, they required VA-ECMO support at Penang General Hospital. Both patients were successfully weaned off ECMO within 48&#xa0;h but faced prolonged hospital stays due to complications. Our experience underscores the importance of aggressive physiotherapy and rehabilitation in managing patients post-ECMO and establishing a successful ECMO center. VA-ECMO can serve as a bridge to recovery for patients with severe type II respiratory failure and hyperdynamic septic shock when managed by a dedicated ECMO team and supported by aggressive rehabilitation efforts.</p>

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Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) for Severe Type II Respiratory Failure and Hyperdynamic Septic Shock: A Case Report

  • 期刊论文

  • 发表日期：

    2025年2月18日

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  • Yen Chuan Chen,
  • Abu Yamin Khamis,
  • Gaithridevi V. Singam,
  • Chew Har Lim

摘要

Severe type II respiratory failure and septic shock are life-threatening conditions that require immediate intervention. The role of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in these cases remains debated. This case series describes two patients with similar presentations—severe type II respiratory failure due to acute exacerbation of poorly controlled bronchial asthma and refractory septic shock. Both had a sequential organ failure assessment (SOFA) score of 15 and met the criteria for severe respiratory failure and acute respiratory distress syndrome (ARDS). Despite adequate fluid resuscitation and high-dose vasopressor and inotropic therapy, they required VA-ECMO support at Penang General Hospital. Both patients were successfully weaned off ECMO within 48 h but faced prolonged hospital stays due to complications. Our experience underscores the importance of aggressive physiotherapy and rehabilitation in managing patients post-ECMO and establishing a successful ECMO center. VA-ECMO can serve as a bridge to recovery for patients with severe type II respiratory failure and hyperdynamic septic shock when managed by a dedicated ECMO team and supported by aggressive rehabilitation efforts.