Make the Diagnosis: Respiratory Riddle

Presentation

Case Findings: An adult male presents with shortage of breath and respiratory failure. This image shows his treatment.

What is your diagnosis?

Learnings

This patient’s acute respiratory distress was caused by swine flu, and the patient was managed by treatment with extracorporeal membrane oxygenation (ECMO).

What to Look For:

Symptoms associated with H1N1 swine flu include respiratory failure, as well as pneumonia, neurological symptoms, and exacerbation of chronic conditions, such as asthma.

When to Use ECMO:

ECMO is a cardiopulmonary support method that is used when other types of mechanical ventilation have failed. ECMO circulates blood through a pump and oxygenator before reinfusing it into the body’s normal circulation. Although ECMO has historically been used to treat severe respiratory distress in newborns, it is increasingly being used as a type of bridge to further treatment.

Outcomes:

The usefulness of ECMO for severe respiratory failure in adults has not been well studied, and ECMO use has been associated with blood clot formation. Data from a Cochrane Database of Systematic Reviews in 2015 suggest that the treatment is best as a rescue therapy and not recommended for routine care.

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Make the Diagnosis: Respiratory Riddle