A Patient with ARDS and Cardiogenic Shock Caused by Streptococcus Pyogenes Successfully Treated by V-A-V ECMO

We performed VV ECMO for a 68-year-old man who had ARDS caused by Streptococcus pyogenes. After 2 days of treatment he had acute cardiogenic shock with refractory VT. Echocardiography showed EF 30%. We planned transition from VV ECMO to VAV ECMO to support cardiopulmonary function. An additional return cannula (15 Fr) was inserted from the left femoral Artery, which was connected to the circuit branch from the original returning cannula. Then we titrated the arterial and venous inflow by applying an adjustable clamp on the venous inflow limb to keep the optimal femoral artery flow, he was successfully switched from VV to VAV ECMO showed on ABG and hemodynamic stable. After 10 days of V-A-V treatment, he was recovered, stopped ECMO supporting and discharged hospital after 47 days.