Extracorporeal Membrane Oxygenation Support in a Young Patient With COVID-19 Infection

Curēus
Gian LimaMaria Camila Paredes

Abstract

Critically ill patients with coronavirus disease 2019 (COVID-19) infection often require mechanical ventilation, and still many of them will progress to worsening hypoxia and death. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) has been used in some centers, but its role in the setting of COVID-19 infection is still unclear to date. We describe a case of a young female patient with obesity but otherwise no other underlying medical conditions who was admitted with respiratory failure secondary to COVID-19. Given her severe acute respiratory distress syndrome (ARDS) with refractory hypoxemia, she was treated with VV-ECMO. After a prolonged hospital course, she improved clinically and was able to have VV-ECMO explanted, after 18 days of extracorporeal therapy. The complexity of ECMO therapy requires a well-trained multidisciplinary team present only at expert centers. The high resource cost is a challenge to the health care system in times of a global pandemic. Considering the limitations of this resource-intensive therapy, clinical judgment is crucial to decide whether ECMO is an appropriate option for the patient. However, for young patients with no underlying conditions who are critically ill despite optimized mecha...Continue Reading

References

Oct 14, 2009·JAMA : the Journal of the American Medical Association·UNKNOWN Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza InvestigatorsMarc Ziegenfuss
Jan 14, 2018·Annals of Intensive Care·Mohammed S AlshahraniWaleed Alhazzani
Aug 14, 2019·JAMA : the Journal of the American Medical Association·Daniel BrodieAlain Combes
Feb 23, 2020·The Lancet. Respiratory Medicine·Zhe XuFu-Sheng Wang
Feb 29, 2020·The New England Journal of Medicine·Wei-Jie GuanUNKNOWN China Medical Treatment Expert Group for Covid-19
Apr 1, 2020·Heart & Lung : the Journal of Critical Care·Silvio A Ñamendys-Silva
Apr 7, 2020·JAMA : the Journal of the American Medical Association·Giacomo GrasselliUNKNOWN COVID-19 Lombardy ICU Network

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