PMC6172994_01
Serial chest radiographs. Serial chest radiographs, anteroposterior view: (A) At 1
month before admission. (B) At the time of admission due to adenovirus pneumonia. (C)
After cardiopulmonary resuscitation and venovenous ECMO implantation. (D) After
conversion to venoarterial ECMO. (E) After intratracheal bone marrow-derived mesenchymal
stem cell injection and extracorporeal membrane oxygenation removal. ECMO,
extracorporeal membrane oxygenation.
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Her baseline oxygen saturation was 90% in ambient air (Fig. 1A). Chest radiography showed widespread reticular pattern and parenchymal bands (Fig. 1B). Therefore, venovenous extracorporeal membrane oxygenation (ECMO) was implanted (a 15F double lumen cannula, blood flow 0.4 L/min; Fig. 1C). For better support, ECMO was changed to venoarterial (a 14F A-cannula and a 14F V-cannula, blood flow 0.9 L/min) after 35 d (Fig. 1D).
Serial chest computed tomographic scan images: (A) At 17 d after admission, before
venovenous ECMO implantation. (B) At 49 d after admission, before conversion to
venoarterial ECMO implantation. (C) At 147 d after admission, 125 d after ECMO
implantation, 25 d after intratracheal bone marrow-derived mesenchymal stem cell
injection, before ECMO removal. Lung fibrosis dramatically improved after bone
marrow-derived mesenchymal stem cell treatment. ECMO, extracorporeal membrane
oxygenation.
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Computed tomographic (CT) scan imaging of the chest was obtained (Fig. 2A). Chest CT on 49 d after admission revealed deterioration and diffused fibrosis of both lung fields (Fig. 2B).