Successful Pulmonary Rescue of Adult Onset Granulomatosis with Polyangiitis Using Extracorporeal Membrane Oxygenation and Window Thoracostomy

Adult onset pulmonary Granulomatosis with Polyangiitis (GPA) is most commonly caused by severe diffuse alveolar hemorrhage. Concurrent cavitary destruction of lung parenchyma in GPA may lead to severe infection requiring window thoracostomy. Cannulation of the right internal jugular vein with an Avalon Elite^® Bi-caval Dual Lumen Catheter for venovenous extracorporeal membrane oxygenation (ECMO) can allow time for adequate lung recovery and acceptable long-term patient outcomes. We demonstrate that this can be safely accomplished in this critically ill patient population.