A 17-yr-old male accidentally inhaled a massive amount of sawdust particles. Severe respiratory distress developed, resulting in subcutaneous emphysema and left pneumothorax. Therefore, sufficient positive-pressure ventilation was inapplicable. Under veno-venous extracorporeal lung assist (ECLA) with an artificial lung, the sawdust particles were removed by broncho-fibroscopy and lung lavage. After 36 h, the patient was weaned from ECLA without further complications.