Case of Acute Gastroenteritis with Guillain-Barré Syndrome and Severe ARDS on VV-ECMO Successfully Underwent Bilateral Lung Transplant

Venovenous extracorporeal membrane oxygenation (VV-ECMO) has become a viable and increasingly utilized option for the treatment of refractory hypoxemia in severe acute respiratory distress syndrome (ARDS).Case description: A 35-year-old gentleman, with no known comorbidities presented with the history of acute gastroenteritis, high-grade fever, and shortness of breath requiring oxygen/noninvasive ventilator support.He was diagnosed as a case of ARDS secondary to viral pneumonia with multiple organ dysfunction syndrome, including azotemia and deranged liver enzymes.In view of the low PaO 2 /FiO 2 ratio with maximum ventilatory support optimization, VV-ECMO was initiated.After approximately 90 days of hospitalization and 45 days on VV-ECMO, he underwent bilateral lung transplant.Conclusion: Most patients considered for ECMO as a bridge to lung transplant have terminal chronic lung disease.The same strategy can be modified for use in the acute care setting, as was demonstrated in our patient with no prior lung disease developing refractory hypoxemia from severe ARDS with no native lung recovery.