Extracorporeal Membrane Oxygenation for Acute Respiratory Failure in a Dog

A 3-year-old West Highland White Terrier was presented to our hospital with dyspnoea following aspiration of barium contrast medium during diagnostic imaging for a suspected oesophageal foreign body (day 0). Barium contrast radiography had revealed a foreign body in the lower oesophagus. During anaesthesia, the patient regurgitated and developed respiratory failure and cyanosis. Despite immediate intubation, suction, and ventilatory management, the respiratory parameters remained poor. Respiratory support with extracorporeal membrane oxygenation (ECMO) allowed to control blood gas parameters, and tracheobronchial lavage with temporary complete airway occlusion was performed. ECMO was withdrawn once the respiratory status normalised. The total support time was 3 h. Considering the possibility of hypoxia-induced brain damage, the patient was extubated on day 1. The dog was alert, changed positions, and drank water independently 5 h after extubation. However, neurological symptoms were observed 1 h later. Cranial magnetic resonance imaging was performed on day 6 because of persistent neurological symptoms. Although no ECMO-related complications, such as cerebral infarction, haemorrhage, or herniation, were observed, the white matter showed hyposignal, indicating hypoxic encephalopathy. The patient died on day 8, without improvement in neurological symptoms. ECMO is an effective treatment option for dogs with respiratory failure, and its prompt introduction could improve survival in applicable cases.