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Case Reports
. 2020 Oct;35(10):2869-2871.
doi: 10.1111/jocs.14829. Epub 2020 Jul 15.

COVID-19 patient bridged to recovery with veno-venous extracorporeal membrane oxygenation

Daniel Rinewalt  1 , Anthony Coppolino  2 , Raghu Seethala  3 , Nirmal Sharma  4 , Ali Salim  5 , Steve Keller  4   6 , Hari R Mallidi  1   2
Affiliations
Case Reports

COVID-19 patient bridged to recovery with veno-venous extracorporeal membrane oxygenation

Daniel Rinewalt et al. J Card Surg. 2020 Oct.

Abstract

Background: In severe cases, the coronavirus disease 2019 (COVID-19) viral pathogen produces hypoxic respiratory failure unable to be adequately supported by mechanical ventilation. The role of extracorporeal membrane oxygenation (ECMO) remains unknown, with the few publications to date lacking detailed patient information or management algorithms all while reporting excessive mortality.

Methods: Case report from a prospectively maintained institutional ECMO database for COVID-19.

Results: We describe veno-venous (VV) ECMO in a COVID-19-positive woman with hypoxic respiratory dysfunction failing mechanical ventilation support while prone and receiving inhaled pulmonary vasodilator therapy. After 9 days of complex management secondary to her hyperdynamic circulation, ECMO support was successfully weaned to supine mechanical ventilation and the patient was ultimately discharged from the hospital.

Conclusions: With proper patient selection and careful attention to hemodynamic management, ECMO remains a reasonable treatment option for patients with COVID-19.

Keywords: cardiovascular pathology; perfusion.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Patient selection, evaluation, and treatment strategies. ARDS, acute respiratory distress syndrome; CHF, congestive heart failure; CKD, chronic kidney disease; DO2, oxygen delivery; ECMO, extracorporeal membrane oxygenation; PAO2, partial pressure of oxygen; PCO2, partial pressure of carbon dioxide; PEEP, positive end‐expiratory pressure; VO2, oxygen consumption; V/Q, ventilation/perfusion
See this image and copyright information in PMC

References

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