*Purpose: Acute Respiratory Distress is a high-risk complication of lung inflammation that has been linked to multiple exogenous agents.

*Methods: We present the case of a 31-year-old male with a recent cadaveric pancreatic/kidney transplant brought to the emergency department one-day post-discharge from transplant surgery with a chief complaint of acute-onset dyspnea.

*Results: After admission to the intensive care unit, the patient developed Adult Respiratory Distress Syndrome (ARDS) with two events of respiratory/cardiac failure. Initial etiology of ARDS was unclear, but upon later interview, the patient admitted to “dabbing” (using a quartz pipe to superheat marijuana rosin into an inhaled vapor) on the same day post-discharge from initial transplant surgery. The patient was successfully resuscitated and placed on veno-arterial Extra Corporeal Circulation Membrane Oxygenation (ECMO) for cardiac and ventilatory support. Patient was successfully decannulated 4 days later. He developed complications related to ECMO therapy, including intracranial bleeding which resolved with surgery. After prolonged hospitalization, he was recovered successfully. On one year follow up, the patient had recovered and was physically active with creatinine 1.2 and normal hemoglobin A1c and insulin-independent, and normal pancreas enzymes.

*Conclusions: This case demonstrates the benefits of a multidisciplinary approach including timely initiation of ECMO to treat severe ARDS, causing by dabbing marijuana.

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