{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:06:55Z","timestamp":1756339615087,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"11","funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["T32GM121318"],"award-info":[{"award-number":["T32GM121318"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,10,30]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:p>Bleomycin treats malignancies, such as germ cell tumours and Hodgkin lymphoma. While efficacious, it can cause severe drug-induced lung injury. We present a 42-year-old patient with stage IIB seminoma treated with radical orchiectomy followed by adjuvant chemotherapy with bleomycin, etoposide and cisplatin. His postbleomycin course was complicated by the rapid onset of hypoxic respiratory failure, progressing to acute respiratory distress syndrome and requiring venovenous extracorporeal membrane oxygenation (VV-ECMO) support. Although the patient was treated with high dose systemic steroids and ultra-protective ventilator strategies to minimise ventilator-induced lung injury while on VV-ECMO, his lung injury failed to improve. Care was withdrawn 29 days later. Lung autopsy revealed diffuse organising pneumonia. We found six case reports (including this one) of bleomycin-induced lung injury requiring VV-ECMO with a cumulative survival of 33% (2\/6). While VV-ECMO may be used to bridge patients to recovery or lung transplant, the mortality is high.<\/jats:p>","DOI":"10.1136\/bcr-2020-236474","type":"journal-article","created":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T16:01:34Z","timestamp":1606147294000},"page":"e236474","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Bleomycin-induced lung injury treated with venovenous extracorporeal membrane oxygenation (ECMO) and ultra-protective ventilator settings"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1247-1371","authenticated-orcid":false,"given":"Mazen Faris","family":"Odish","sequence":"first","affiliation":[{"name":"Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William Cameron","family":"McGuire","sequence":"additional","affiliation":[{"name":"Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Thistlethwaite","sequence":"additional","affiliation":[{"name":"Surgery, Division of Cardiovascular and Thoracic Surgery, University of California San Diego, La Jolla, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura E","family":"Crotty Alexander","sequence":"additional","affiliation":[{"name":"Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,11,23]]},"reference":[{"key":"2025082713143764000_13.11.e236474.1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-09-378414"},{"key":"2025082713143764000_13.11.e236474.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2015.04.012"},{"key":"2025082713143764000_13.11.e236474.3","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02560"},{"key":"2025082713143764000_13.11.e236474.4","doi-asserted-by":"publisher","DOI":"10.1378\/chest.86.5.723"},{"key":"2025082713143764000_13.11.e236474.5","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/imi.0000000000000340","article-title":"Veno-Venous extracorporeal membrane oxygenation use in the treatment of bleomycin pulmonary toxicity","volume":"12","author":"Shah","year":"2017","journal-title":"Innovations"},{"key":"2025082713143764000_13.11.e236474.6","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1532\/hsf.1569","article-title":"Thrombosis of the right internal jugular vein is not a contraindication to ambulatory Veno-Venous extracorporeal membrane oxygenation with a Bicaval Dual-Lumen, single cannula system","volume":"19","author":"Kronfli","year":"2016","journal-title":"Heart Surg Forum"},{"key":"2025082713143764000_13.11.e236474.7","first-page":"1","article-title":"Bechir M extracorporeal membrane oxygenation in presence of severe chemotherapy-induced (bleomycin, Etoposid and Efosfomid) interstitial fibrosis","volume":"1","author":"Scherrer","year":"2004","journal-title":"SOJ Anesthesiol Pain Manag"},{"key":"2025082713143764000_13.11.e236474.8","first-page":"2379","article-title":"Fatal bleomycin-induced pulmonary fibrosis in case of seminoma open","volume":"2","author":"Galcaianu","year":"2016","journal-title":"Journal of clinical and medical case reports"},{"key":"2025082713143764000_13.11.e236474.9","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2016-0437"},{"key":"2025082713143764000_13.11.e236474.10","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1097\/01.ccm.0000510276.16861.01","article-title":"1603.","volume":"44","author":"Mailman","year":"2016","journal-title":"Crit Care Med"},{"key":"2025082713143764000_13.11.e236474.11","doi-asserted-by":"crossref","unstructured":"Amato MBP , Meade MO , Slutsky AS , et al . Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 2015.","DOI":"10.1056\/NEJMsa1410639"},{"key":"2025082713143764000_13.11.e236474.12","unstructured":"Schmidt M , Pham T , Arcadipane A , et al . Mechanical ventilation management during ECMO for ARDS: an international multicenter prospective cohort. 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