Extracorporeal membrane oxygenation in pediatric respiratory failure secondary to smoke inhalation injury.

Extracorporeal membrane oxygenation (ECMO) was used successfully in two children who had respiratory failure secondary to smoke inhalation injury. The first involved a 20% body surface area burn with initial carboxyhemoglobin of 26%. The patient developed varicella pneumonia, which complicated his respiratory failure; he was placed on ECMO for 7 days. The second infant had a 35% body surface area burn and carboxyhemoglobin of 30%. He underwent debridement and allografting while on ECMO, and was decannulated after 13 days. Anticoagulation for ECMO did not significantly interfere with dressing changes. Both patients had definitive autografting and were discharged home breathing room air.