Novel ECMO Strategy Helps Keep Man Alive After Infection 'Melted' His Lungs

Researchers suggest 'total artificial lung' approach might make double-lung transplant safer

Jan. 30, 2026 at 10:39am

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Researchers reported a novel "total artificial lung" approach to extracorporeal support for a patient who needed bilateral lung transplantation due to infection. The 33-year-old man developed acute respiratory distress syndrome (ARDS) triggered by the flu, and pneumonia caused by carbapenem-resistant Pseudomonas aeruginosa progressively necrotized his lungs. Despite full venoarterial extracorporeal membrane oxygenation (ECMO) support, the man repeatedly went into cardiac arrest. To allow a chance for survival, both lungs were removed and the patient switched to ECMO with a flow-adaptive shunt between the right pulmonary artery and right atrium for 48 hours until lungs became available for transplantation.

Why it matters

This case highlights the potential for using a novel "total artificial lung" approach to extracorporeal support to help patients with severe lung damage caused by respiratory viruses or infections, even in acute settings, when a lung transplant can be lifesaving. The approach addresses the hemodynamic challenges that can arise after bilateral pneumonectomy.

The details

Researchers used a flow-adaptive shunt between the right pulmonary artery and right atrium to act as an effective surrogate for the lost pulmonary vascular capacitance, providing an alternative low-resistance pathway for excess right ventricular output and recirculating blood according to pressure differentials. This was suggested to be safer than creating a pulmonary artery to left atrial shunt, which could risk causing systemic embolism.

  • Over the next 6 weeks, pneumonia caused by carbapenem-resistant Pseudomonas aeruginosa progressively necrotized the patient's lungs.
  • The patient was on full venoarterial extracorporeal membrane oxygenation (ECMO) support for 48 hours until lungs became available for transplantation.

The players

Ankit Bharat, MD

Researcher from the Canning Thoracic Institute at Northwestern University in Chicago.

Stephanie Chang, MD

Surgical director of lung transplantation at the NYU Langone Transplant Institute in New York City.

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What they’re saying

“When the infection is so severe that the lungs are melting, they're irrecoverably damaged.”

— Ankit Bharat, Researcher (Medpage Today)

“In my practice, young patients die almost every week because no one realized that transplantation was an option.”

— Ankit Bharat, Researcher (Medpage Today)

“Thankfully, this is a very rare situation, but for these patients who would otherwise die, it's reassuring that there are these techniques ... and that other centers have done this as well.”

— Stephanie Chang, Surgical director of lung transplantation (Medpage Today)

What’s next

Larger studies are needed to determine if specific transcriptional or spatial signatures can reliably distinguish irreversible lung injury from potentially recoverable ARDS, as delayed recognition of nonrecoverable lung injury is associated with high mortality and remains a central obstacle to timely transplant referral.

The takeaway

This case demonstrates the potential for using a novel "total artificial lung" approach to extracorporeal support to help save the lives of patients with severe lung damage caused by respiratory viruses or infections, even in acute settings, when a lung transplant may be the only option for survival.