Case Reports

ECMO Membrane Lung Failure due to Hypertriglyceridemia: A Case Report and Review of the Literature

^* Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington
^† Division of Trauma, Acute Care Surgery & Surgical Critical Care, University of California Davis School of Medicine, Sacramento, California
^‡ Division of Trauma, Burn & Critical Care Surgery, Harborview Medical Center, University of Washington School of Medicine, Seattle, Washington

Address correspondence to: Jenelle H. Badulak, MD, Acting Assistant Professor, University of Washington, 328B NW 41ST ST, Seattle, WA 98107. E-mail: badulakj@uw.edu

Received: 25 April 2020
Accepted: 3 August 2020

Abstract

The deleterious effects of high serum lipid content on the membrane lung (ML) during extracorporeal membrane oxygenation (ECMO) are sparsely documented, and the threshold of lipemia-induced membrane failure is poorly described. We present a case of a patient on venovenous ECMO who developed ML failure after 7 days due to moderate to severe hypertriglyceridemia (700–800 mg/dL). ML failure was exhibited by impaired gas exchange and high transmembrane pressures, and there was notable lipemic layering in the circuit immediately after decannulation. This case demonstrates that in addition to patients with extreme lipemia, ML failure can also occur in patients with moderate to severe hypertriglyceridemia. Hypertriglyceridemia should be suspected in patients with high transmembrane pressures and ML failure not attributable to thrombosis, and these patients may require frequent ML changes if a prolonged ECMO run is required.