Abstract
A long term Extracorporeal Lung Assist (ECLA) for full 38 days was carried out in a 14-month-old infant manifesting severe respiratory failure and unconsciousness due to measles pneumonia. The patient regained consciousness within a few days under ECLA, but many troubles in ECLA management and patient treatments occurredin the course. Venovenous perfusion was changed to the venoarterial on the 12th day. Chest tube insersion for pneumothorax and repo-sittioning of the ECLA perfusion cannula for proper site triggerred bleeding from the wound, but was fixed by haptoglobin. Six artificial lung were necessitated in total during 38 days because of intra-circuit clotting and tube cracking. Besides routine care by antibiotics andγ-globulin for pneumonia, special treatments such as intermittent massive steroid administration (pulse th-erapy), intratracheal lavage by normal saline, urokinase and f ibrinolysin, intratracheal artificial surfactant supplementation and immunological treatment by interleukin-2 or lymphocyte-rich plasma boosted in his mother for 2 weeks by measles vaccine, were tried without salutary results. During ECLA, the patient consciousness was kept clear until near the end. ECLA was disconti-nu ed when he lost consciousness and all the treatments were found unfruitful. Though this case wa s unsuccessful, the feasibility of ECLA as total life support system was demonstrated.
