Open AccessExtracorporeal membrane oxygenation (ECMO) for COVID-19 patients
Author(s) -
Surat Tongyoo,
Suneerat Kongsayreepong
Publication year - 2021
Publication title -
clinical critical care
Language(s) - English
Resource type - Journals
ISSN - 2774-0048
DOI - 10.54205/ccc.v29i.252413
Subject(s) - extracorporeal membrane oxygenation , medicine , mechanical ventilation , cytokine storm , anesthesia , respiratory failure , partial thromboplastin time , intensive care unit , heparin , covid-19 , extracorporeal , intensive care medicine , coagulation , disease , infectious disease (medical specialty)
During the current outbreak of coronavirus disease 2019 (COVID-19), Extracorporeal Membrane Oxygenation (ECMO) support could be considered as the rescue treatment from life threatening condition among severe COVID-19 patients who did not respond to mechanical ventilation. We propose that veno-venous ECMO should be considered if patient has persistence PaO2:FiO2 ratio lower than 100 mmHg after appropriate mechanical ventilator adjustment, muscle relaxant and prone position. During ECMO support, treatment against cytokine storm, including non-selective immune suppression with systemic steroid, or selective interleukin-6 inhibition and Janus Kinase inhibition should be considered. Heparin infusion is still the recommended anticoagulant to maintain activated partial thromboplastin time (APTT) ratio range 1.5-2.0. The overall hospital mortality was comparable with respiratory failure patients, requiring ECMO support from other causes, which was reported about 37-50%. The decision to initiate ECMO could be depended on the individual hospital capacity and treatment availability.