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Extracorporeal membrane oxygenation (ECMO) use is increasing in frequency for patients with refractory hypoxemia, and with increasing regionalization of care, safe transport of hypoxemic patients only becomes more important. In this series, four cases are presented of young patients with severe hypoxemic respiratory failure from Legionnaires\u2019 disease transported on inhaled epoprostenol to ECMO centers for consideration of cannulation. With continued climate changes, Legionella and other pathogens are likely to be a continued threat. As such, optimizing oxygenation to allow for transport should continue to be a priority for critical care transport (CCT) services.<\/jats:p>","DOI":"10.1017\/s1049023x19005211","type":"journal-article","created":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T03:56:43Z","timestamp":1578542203000},"page":"109-114","source":"Crossref","is-referenced-by-count":2,"title":["Inhaled Epoprostenol to Facilitate Safe Transport in Legionnaires\u2019 Disease"],"prefix":"10.1017","volume":"35","author":[{"given":"Corrine","family":"Foster","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Frakes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica","family":"Puopolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis","family":"McNulty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark S.","family":"Saia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"Hourihan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Flynn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7477-7531","authenticated-orcid":false,"given":"Susan R.","family":"Wilcox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,1,9]]},"reference":[{"key":"S1049023X19005211_ref35","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jix531"},{"key":"S1049023X19005211_ref33","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1111\/j.1600-6143.2011.03938.x","article-title":"Legionellosis--United States, 2000\u20132009","volume":"12","author":"Hicks","year":"2012","journal-title":"Am J Transplant"},{"key":"S1049023X19005211_ref28","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200708-1214OC"},{"key":"S1049023X19005211_ref27","doi-asserted-by":"publisher","DOI":"10.1378\/chest.125.4.1579"},{"key":"S1049023X19005211_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2013.03.006"},{"key":"S1049023X19005211_ref21","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2017.06.66"},{"key":"S1049023X19005211_ref25","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214103"},{"key":"S1049023X19005211_ref20","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05268"},{"key":"S1049023X19005211_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.amj.2016.01.004"},{"key":"S1049023X19005211_ref17","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318160a5b4"},{"key":"S1049023X19005211_ref16","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00029-14"},{"key":"S1049023X19005211_ref15","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.0230"},{"key":"S1049023X19005211_ref14","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15081612"},{"key":"S1049023X19005211_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.amj.2015.07.006"},{"key":"S1049023X19005211_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61069-2"},{"key":"S1049023X19005211_ref7","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.04760"},{"key":"S1049023X19005211_ref13","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318258431e"},{"key":"S1049023X19005211_ref32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0094057"},{"key":"S1049023X19005211_ref29","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201409-1634OC"},{"key":"S1049023X19005211_ref10","doi-asserted-by":"publisher","DOI":"10.1177\/0885066615623202"},{"key":"S1049023X19005211_ref36","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3605-8"},{"key":"S1049023X19005211_ref34","doi-asserted-by":"publisher","DOI":"10.1086\/590557"},{"key":"S1049023X19005211_ref24","doi-asserted-by":"publisher","DOI":"10.1177\/1753465815599345"},{"key":"S1049023X19005211_ref2","first-page":"7","article-title":"Legionella pneumonia associated with severe acute respiratory distress syndrome and diffuse alveolar hemorrhage - 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