Extracorporeal membrane oxygenation (ECMO) for COVID-19 patients

ECMO for COVID-19

Authors

  • Surat Tongyoo Faculty of Medicine, Siriraj Hospital, Mahidol University
  • Suneerat Kongsayreepong Department of Anesthesia, Faculty of Medicine, Siriraj Hospital, Mahidol University

Keywords:

ECMO, COVID-19, Acute respiratory distress syndrome, ARDS, VV-ECMO, Extracoporeal membrane oxygenator

Abstract

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.

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References

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Published

2021-09-17

How to Cite

1.
Tongyoo S, Kongsayreepong S. Extracorporeal membrane oxygenation (ECMO) for COVID-19 patients: ECMO for COVID-19 . Clin Crit Care [Internet]. 2021 Sep. 17 [cited 2022 May 23];29:2021:e0005. Available from: https://he02.tci-thaijo.org/index.php/ccc/article/view/252413

Issue

Section

Short Review