Veno‐venous extracorporeal membrane oxygenation support in the resuscitation from extreme metabolic acidosis (pH<6.5) after drowning cardiac arrest: a case report

Veno‐venous extracorporeal membrane oxygenation support in the resuscitation from extreme metabolic acidosis (pH<6.5) after drowning cardiac arrest: a case report

Veno-venous extracorporeal membrane oxygenation (VV-ECMO), Extreme metabolic acidosis, Drowning
cardiac arrest (DCA), Targeted temperature management (TTM), Cerebral resuscitation

Background Resuscitation in drowning victim with cardiac arrest is difficult because of severe metabolic acidosis
and multiple organ dysfunction. There is insufficient evidence to support that veno-venous extracorporeal membrane
oxygenation (VV-ECMO) is beneficial for patient.
Case presentation A 44-year-old female was trapped under river when she attempted to rescue her drowning

father. Furthermore, she underwent a loss of consciousness, with extreme metabolic acidosis, hypothermia and hypo-
tension. Hence, the VV-ECMO, continuous renal replacement therapy (CRRT) and other resuscitative infusion were

required. In this case, the patient did not experience any complication or neurologic deficit and reaching a complete
recovery after 21 days of hospitalization.
Conclusions Our case adds further concerns in supporting a patient with extreme metabolic acidosis (pH<6.5) and

hypothermia after severe drowning cardiac arrest, including extracorporeal life support, renal support, targeted tem-
perature management, cerebral resuscitation, etc., due to the reversible nature of this condition.

Keywords Veno-venous extracorporeal membrane oxygenation (VV-ECMO), Extreme metabolic acidosis, Drowning
cardiac arrest (DCA), Targeted temperature management (TTM), Cerebral resuscitation

Yueyang Chai1†, Xinyi Zhang2† and Hong Liu1*

https://doi.org/10.1186/s12245-023-00501-4

2023

Peri Irawan

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