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Case Reports
. 2021 Jun;24(2):287-292.
doi: 10.1007/s10047-020-01209-5. Epub 2020 Sep 19.

Mobile ECMO in COVID-19 patient: case report

Martínez Daniela  1   2 , Salech Felipe  3   4 , Sint Jan Van Nicolette  5   6   7 , Regueira Tomás  5 , Villalabeitia Eli  6   7 , Rufs Jorge  7   8 , Fajardo Christian  6   7 , Castillo Roberto  8 , Iñiguez Jose  9 , Durán Luisa  4 , Díaz Rodrigo  10   11
Affiliations
Case Reports

Mobile ECMO in COVID-19 patient: case report

Martínez Daniela et al. J Artif Organs. 2021 Jun.

Abstract

At July 25, 2020, WHO had recorded more than 16.1 million confirmed COVID-19 cases, 1% of them developed critical illness. These patients can experience rapid progression to profound hypoxemia and severe acute respiratory distress syndrome (ARDS). Some patients, despite receiving lung-protective ventilation and maximal medical therapy, develop refractory hypoxemia, rendering candidates for extracorporeal membrane oxygenation (ECMO) support. Centers with experience in this technique are available only in a few reference hospitals and some patients are too ill to be transferred with conventional mechanical ventilation so they need mobile ECMO (interhospital transport under ECMO). Here we report the first interhospital extracorporeal membrane oxygenation transport of a COVID-19 patient in Chile, showing that it is feasible and safe to transfer a COVID-19 patient under ECMO support if a mobile ECMO program is correctly implemented and the particularities of protective measures are properly taken.

Keywords: ARDS; COVID-19; ECMO; Mobile ECMO; Personal protective equipment.

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Conflict of interest statement

Felipe Salech is currently receiving a Grant from “FONDECYT” (Chilean government research Grant) #11190882. The remaining authors have disclosed that they do not have any conflicts of interest.

Figures

Fig. 1
Fig. 1
CT Scan at cannulation time: shows a representative CT slice of the lung obtained 2 cm above the diaphragm dome. Mechanical ventilator setup: volume controlled ventilation 6 mL/Kg ideal body weight, Respiratory Rate 28, PEEP 16 cm H2O, FiO2 70%, peak inspiratory pressure 37 cm H2O, plateau pressure 27 cm H2O
Fig. 2
Fig. 2
ECMO air transport: Airborne transfer lasted 4.5 h (3019 km distance). During the flight, the patient remained with her endotracheal tube clamped. All the team members, used air-borne transmission adequate PPE
Fig. 3
Fig. 3
Location of the 15 ECMO centers in Chile. Chile is located in southwest region of South America; its population is 17.9 million people in over 4.270 km from north to south and 756.945 km2 including the island territory. Fifteen clinical centers have the ability to provide ECMO support distributed in only 6 cities [10 in Santiago (black star), and 1 in Concepción, Talcahuano, Viña del Mar, Antofagasta and Temuco (blue dots)]. The arrow shows the distance traveled in mobile ECMO with the patient
See this image and copyright information in PMC

References

    1. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579:270–273. doi: 10.1038/s41586-020-2012-7. - DOI - PMC - PubMed
    1. Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomedica Mattioli 1885. 2020;91:157–160. - PMC - PubMed
    1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA J Am Med Assoc. 2020;323:1239–1242. doi: 10.1001/jama.2020.2648. - DOI - PubMed
    1. Brodie D, Bacchetta M. Extracorporeal membrane oxygenation for ARDS in adults. N Engl J Med. 2011;365:1905–14. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22087681. Cited 21 Apr 2020. - PubMed
    1. Bartlett RH, Ogino MT, Brodie D, McMullan DM, Lorusso R, MacLaren G, et al. Initial ELSO guidance document. ASAIO J. 2020;8:E113–E113. - PMC - PubMed

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