“…Conventional treatment of severe NPPE is focused on relieving the upper airway obstruction, positive pressure ventilation, and medication therapy including diuretics, with resolution of most cases. Case reports have described the need for delayed veno-venous extracorporeal membrane oxygenation (VV ECMO) in cases of refractory hypoxia not responding to initial therapies 2,3,4,5 . However, the use of VV ECMO as acute rescue therapy in the post anesthesia care unit (PACU) for NPPE-induced severe hypoxic respiratory failure, shock, and peri-arrest physiology is yet to be described in the literature.…”