LAUSR

PATIENTS SUPPORTED on peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) can have differential hypoxemia if cardiac function is regained in the clinical setting of poor gas exchange within the native pulmonary bed. Differential hypoxemia is demonstrated by hypoxemia of the upper extremities, brain, and myocardium while adequate oxygen perfusion is maintained in the lower extremities through extracorporeal membrane oxygenation (ECMO). Management of differential hypoxemia in this patient was complicated by acute onset of neurogenic pulmonary edema (NPE), an uncommon complication of anoxic brain injury that compromised oxygenation through the native pulmonary bed. To the authors’ knowledge, this is the first case report of rescue VA-ECMO for cardiac arrest resulting in differential hypoxemia in the setting of NPE.