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COVID‐19 patient bridged to recovery with veno‐venous extracorporeal membrane oxygenation
Author(s) -
Rinewalt Daniel,
Coppolino Anthony,
Seethala Raghu,
Sharma Nirmal,
Salim Ali,
Keller Steve,
Mallidi Hari R.
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14829
Subject(s) - medicine , extracorporeal membrane oxygenation , mechanical ventilation , respiratory failure , covid-19 , intensive care medicine , oxygenation , supine position , hemodynamics , anesthesia , disease , infectious disease (medical specialty)
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.