Research Article

Life threatening sickle chest syndrome treated with extracorporeal membrane oxygenation.

Br Med J (Clin Res Ed) 1987; 294 doi: http://dx.doi.org/10.1136/bmj.294.6564.81 (Published 10 January 1987) Cite this as: Br Med J (Clin Res Ed) 1987;294:81
  1. D S Gillett,
  2. K E Gunning,
  3. E H Sawicka,
  4. A J Bellingham,
  5. R J Ware

    Abstract

    A young West Indian woman with established sickle cell disease developed a severe episode of sickle chest syndrome. Conventional treatment including exchange transfusions and mechanical ventilation was to no avail, and an infusion of epoprostenol also failed to halt her worsening condition. When her arterial oxygen tension (PaO2) had fallen to 6.5 kPa (49 mm Hg) extracorporeal membrane oxygenation was instituted. Within two days her PaO2 was greatly improved (maximum 11.6 kPa; 87 mmHg), and by the sixth day pulmonary vascular resistance was reduced and angiography showed reperfusion of many vessels. The patient recovered and six months later showed a transfer factor close to the predicted range and normal spirometric values. Extracorporeal membrane oxygenation should be considered for severe sickle chest syndrome when conventional methods of artificial ventilation fail.