[Venovenous extracorporeal membrane oxygenation in an elderly patient with severe respiratory failure--report of a case].

A 69-year-old woman, who developed acute respiratory distress syndrome (ARDS) after coronary artery bypass grafting, underwent venovenous extracorporeal membrane oxygenation (V-V ECMO) because conventional ventilatory support was ineffective. We used a covalently bonded heparin surface ECMO system, including an artificial lung, a centrifugal pump, cannulas, tubing and connectors, that was maintained with low-dose systemic heparinization, the patient was weaned from ECMO after 186 hours. During ECMO, her platelet count was about half of the initial level and markedly elevated thrombin-antithrombin complex (TAT), plasmin-alpha 2 plasmin inhibitor complex (PIC) and D-dimer were decreased by the use of heparin and protease inhibitors. V-V ECMO seems to be useful even in patients with severe adult respiratory failure and can be performed safely if a heparin covalent circuit is applied.