Extracorporeal Membrane Oxygenation Support as a Bridge to Recovery during Chemotherapy in a Young Patient with Metastatic Choriocarcinoma and Severe Acute Respiratory Distress Syndrome

Extracorporeal Membrane Oxygenation to Facilitate Chemotherapy—Moving the Goalposts!

Extracorporeal membrane oxygenation (ECMO) is a lifesaving intervention in critically ill patients with cardiorespiratory failure. ECMO in patients with cancer is generally contraindicated not only to conserve precious resources and properly direct use but also due to a multitude of associated physiological derangements in these subsets of patients. ECMO in patients with disseminated cancer is an automatic rule-out except for anecdotal reports. Despite this, select patients with metastatic chemotherapy-sensitive cancer may benefit from ECMO as a bridge to therapy. In this report, we describe the use of veno-arterial-venous ECMO (VAV-ECMO) as a bridge to facilitate chemotherapy in a patient with cardiorespiratory failure secondary to a chemotherapy-sensitive metastatic non-seminomatous germ cell tumor.

Acute cardiopulmonary failure in a young woman with high-risk gestational trophoblastic neoplasia: A case of induction chemotherapy during extracorporeal membrane oxygenation

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Early use of extracorporeal membrane oxygenation (ECMO) is valuable when pulmonary tumor burden from GTN is high.

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Induction chemotherapy of cisplatin and etoposide was administered during ECMO successfully.

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The induction chemotherapy regimen led to exponential decline in beta-HCG after 1 cycle.

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Collaboration of subspecialists is necessary to treat coexisting malignancy and cardiopulmonary failure associated with GTN.