Open AccessCOVID-19 Respiratory Failure: Targeting Inflammation on VV-ECMO Support
Author(s) -
Matthew E. Hartman,
Roland A. Hernández,
Krish Patel,
Teresa Wagner,
Tony W. Trinh,
Anne B. Lipke,
Eric Yim,
Juan N. Pulido,
John M. Pagel,
Samuel Youssef,
John L. Mig
Publication year - 2020
Publication title -
asaio journal
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.961
H-Index - 66
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0000000000001177
Subject(s) - covid-19 , inflammation , medicine , respiratory failure , respiratory system , intensive care medicine , betacoronavirus , virology , disease , outbreak , infectious disease (medical specialty)
The outbreak of novel coronavirus (SARS-CoV-2) that causes the respiratory illness COVID-19 has led to unprecedented efforts at containment due to its rapid community spread, associated mortality, and lack of immunization and treatment. We herein detail a case of a young patient who suffered life-threatening disease and multiorgan failure. His clinical course involved rapid and profound respiratory decompensation such that he required support with venovenous extracorporeal membrane oxygenation (VV-ECMO). He also demonstrated hyperinflammation (C-reactive protein peak 444.6 mg/L) with severe cytokine elevation (Interleukin-6 peak > 3000 pg/ml). Through treatment targeting hyperinflammation, he recovered from critical COVID-19 respiratory failure and required only 160 hours of VV-ECMO support. He was extubated 4 days after decannulation, had progressive renal recovery, and was discharged to home on hospital day 24. Of note, repeat SARS-CoV-2 test was negative 21 days after his first positive test. We present one of the first successful cases of VV-ECMO support to recovery of COVID-19 respiratory failure in North America.