Pulmonary toxicity is a devastating complication of bleomycin chemotherapy. This 
insult is likely exacerbated by the free radical injury induced by high inspired 
oxygen content, which is required to support these patients. Traditional 
treatment consists of high-dose corticosteroids. We report the case of a 
45-year-old man who developed bleomycin pulmonary toxicity, which failed to 
respond to treatment with high-dose corticosteroids. We used protective 
mechanical ventilatory settings while supported on veno-venous extracorporeal 
membrane oxygenation using a bicaval dual-lumen, single cannula system to allow 
for lung recovery. This case demonstrates the feasibility of using veno-venous 
extracorporeal membrane oxygenation to treat bleomycin pulmonary toxicity in a 
patient who has failed traditional therapy.