# Successful Treatment of Refractory Status Asthmaticus With Veno-Venous Extracorporeal Membrane Oxygenation (VV ECMO): A Case Report

## TL;DR

A 46-year-old man with severe asthma was successfully treated with ECMO after all other treatments failed.

## Contribution

This case report highlights the successful use of VV ECMO in treating refractory status asthmaticus.

## Key findings

- The patient was successfully treated with VV ECMO after failing conventional therapies.
- The patient was discharged home 11 days after ICU admission.
- VV ECMO may be a viable option for refractory status asthmaticus when other treatments fail.

## Abstract

Refractory status asthmaticus is an extreme form of asthma exacerbation characterized by hypoxemia, hypercarbia, and secondary respiratory failure and is considered a medical emergency. Mechanical ventilation and maximal medical therapy are often required for treatment, but they frequently fail to provide a resolution. Extracorporeal membrane oxygenation (ECMO), however, has increasingly been used as an unconventional treatment modality if all others fail. Here, we report the case of a 46-year-old male who presented to the emergency department (ED) with shortness of breath. The patient demonstrated signs and symptoms of refractory status asthmaticus with significant wheezing and accessory muscle use on physical exam and failed to respond to maximal therapy, including bronchodilators, high-dose steroids, magnesium sulfate, heliox, noninvasive ventilation, inhaled anesthetics, and mechanical ventilation. Ultimately the patient was placed on veno-venous (VV) ECMO, remained in the intensive care unit (ICU) for seven days, and was discharged to home on day 11 post-ICU admission.