Veno-venous extracorporeal membrane oxygenation support during lung volume reduction surgery for a severe respiratory failure patient with emphysema

The use of extracorporeal membrane oxygenation (ECMO) in adults has increased in popularity and importance for the support of patients with cardiac or pulmonary failure, but rarely been described as a means of support during anaesthesia and surgery. We report the case of a patient who required lung volume reduction because of emphysema where veno-venous ECMO was required both during surgery and for the first four days postoperatively. We describe the anaesthetic management of this patient who had severe respiratory failure, review other alternatives and discuss why ECMO was particularly suited to this case.