Unilateral lung diseases such as unilateral pneumonia, trauma or pulmonary hemorrhage can cause profound
hypoxemic respiratory failure necessitating mechanical ventilation. These disorders are characterized by marked
asymmetry in lung mechanics, with the affected lung having a lower compliance compared to the healthier lung,
and management involves complex strategies such as simultaneous independent lung ventilation. However, such
strategies can be challenging in pediatric populations due to technical limitations, and also lead to ventilator
induced lung injury. We report two unique cases that support the use of venovenous extracorporeal membrane
oxygenation as an alternative strategy for management of unilateral lung disease in children.
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