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He was started on inhaled isoflurane with improvement in peak airway pressures and respiratory acidosis, allowing for prompt weaning from V-V ECMO and extubation. Inhaled volatile anaesthetics exert a direct action on bronchiole smooth muscle causing relaxation with significant effect despite severely impaired pulmonary function. This treatment in patients on ECMO may allow for earlier decannulation and decreased risk of coagulopathy, ECMO circuit failure, infection, renal failure, pulmonary haemorrhage and central nervous system haemorrhage. However, major limitations exist in delivering volatile anaesthetics, which may make use inefficient and costly despite efficacy.<\/jats:p>","DOI":"10.1136\/bcr-2019-231507","type":"journal-article","created":{"date-parts":[[2020,1,16]],"date-time":"2020-01-16T04:35:38Z","timestamp":1579149338000},"page":"e231507","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Volatile anaesthetic for treatment of respiratory failure from status asthmaticus requiring extracorporeal membrane oxygenation"],"prefix":"10.1136","volume":"13","author":[{"given":"Joseph E","family":"LaGrew","sequence":"first","affiliation":[{"name":"Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin Robert","family":"Olsen","sequence":"additional","affiliation":[{"name":"Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3990-1485","authenticated-orcid":false,"given":"Amanda","family":"Frantz","sequence":"additional","affiliation":[{"name":"Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,15]]},"reference":[{"key":"2025082710311081000_13.1.e231507.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-8707(37)90143-6"},{"key":"2025082710311081000_13.1.e231507.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-8707(39)90472-7"},{"key":"2025082710311081000_13.1.e231507.3","doi-asserted-by":"publisher","DOI":"10.1177\/0885066609344836"},{"key":"2025082710311081000_13.1.e231507.4","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/00000542-198202000-00005","article-title":"Mechanism of action of inhalational anesthesia on airways","volume":"56","author":"Hirshman","year":"1982","journal-title":"Anesthesiology"},{"key":"2025082710311081000_13.1.e231507.5","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1097\/00000542-199006000-00017","article-title":"Direct and neurally mediated effects of halothane on pulmonary resistance in vivo","volume":"72","author":"Warner","year":"1990","journal-title":"Anesthesiology"},{"key":"2025082710311081000_13.1.e231507.6","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200212000-00032"},{"key":"2025082710311081000_13.1.e231507.7","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/anae.12593","article-title":"Effects of inhalational anaesthetics in experimental allergic asthma","volume":"69","author":"Burburan","year":"2014","journal-title":"Anaesthesia"},{"key":"2025082710311081000_13.1.e231507.8","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000255046.06058.58"},{"key":"2025082710311081000_13.1.e231507.9","doi-asserted-by":"publisher","DOI":"10.1097\/CPM.0b013e3181bdff38"},{"key":"2025082710311081000_13.1.e231507.10","first-page":"13","article-title":"Status asthmaticus in adult patients","volume":"24","author":"Young","year":"2006","journal-title":"Hosp Phys"},{"key":"2025082710311081000_13.1.e231507.11","doi-asserted-by":"crossref","DOI":"10.1186\/1472-6963-6-163","article-title":"Cesar: conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure","volume":"6","author":"Peek","year":"2006","journal-title":"BMC Health Serv Res"},{"key":"2025082710311081000_13.1.e231507.12","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200208-902SO"},{"key":"2025082710311081000_13.1.e231507.13","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0b013e3181901ea5"},{"key":"2025082710311081000_13.1.e231507.14","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s10047-018-1030-9","article-title":"Inhalative sedation with small tidal volumes under venovenous ECMO","volume":"21","author":"Rand","year":"2018","journal-title":"J Artif Organs"},{"key":"2025082710311081000_13.1.e231507.15","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1213\/ANE.0000000000001915","article-title":"Inhaled sedation in patients with acute respiratory distress syndrome undergoing extracorporeal membrane oxygenation","volume":"125","author":"Meiser","year":"2017","journal-title":"Anesth Analg"},{"key":"2025082710311081000_13.1.e231507.16","unstructured":"Butterworth JF , Mackey DC , Wasnick JD . 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