Successful Application of Extracorporeal Membrane Oxygenation in an Adult Burn Patient with Smoke Inhalation and Adult Respiratory Distress Syndrome after Explosive Injury by Flash Bang Grenade

Background:The major cause of mortality in severe burn injury is adult respiratory distress syndrome (ARDS).Aim and Objectives:We report the successful use of extracorporeal membrane oxygenation (ECMO) to treat an adult burn patient with inhalation injury and subsequent ARDS.Materials and Methods:The patient was a 48-year-old man who had extensive explosive burn injuries (55% total body surface area) to the face, chest wall, back, and left arm complicated by open fractures of both lower legs and inhalation injury. Immediate ventilator support and adequate fluid resuscitation were provided; however, low oxygen saturation occurred at day 5, and refractory ARDS was diagnosed with failed volume control ventilation. He was then treated with veno-venous ECMO and subsequently received wound debridement during ECMO support at day 7.Results:The duration of ECMO use was 384 hours, and he was weaned off the ventilator at day 40 with gradual improvement in respiratory parameters.Conclusion:The outcome indicated that ECMO may be useful for overcoming intractable ARDS complicated with extensive burns and inhalation injury.