VV Extracorporeal Membrane Oxygenation Experience during the COVID 19 Pandemic
Cassandra soto, Zoee D'Costa, Marlena Sabatino, Hirohisa Ikegami, Mark J. Russo, Leonard Lee, Anthony Lemaire
Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
OBJECTIVE:The SARS-CoV-2 (COVID19) pandemic has significantly impacted medical care. COVID19 often causes respiratory failure, VV ECMO has been used to maintain oxygenation in patients with respiratory collapse. We present three COVID19-positive patients that required VV ECMO.
METHODS: This is a case series of three COVID19-positive patients requiring VV ECMO identified through retrospective chart review of all patients between March 23rd, 2020 and May 26th, 2020.
RESULTS: 72-year-old male with no past medical history presented with worsening shortness of breath (SOB), and fevers. Tested COVID19 positive and chest X-ray (CXR) demonstrated bilateral patchy infiltrates. On hospital day (HD) 13, patient was intubated and later requiring VV ECMO which continued for 11 days. Despite medical optimization, patient failed to show signs or symptoms of recovery and ultimately expired. 43-year-old male with no existing medical conditions known to be COVID19 positive presented with fever and SOB. On HD10 patient was intubated and required VV ECMO support for 82 days. After complicated hospital course of 103 days, patient was discharged to acute rehabilitation facility. 35-year-old male presented with severe hypoxia, fevers, and SOB. Tested COVID19 positive and CXR demonstrated lung opacities. On HD11, patient decompensated, requiring intubation and VV ECMO which continued for 62 days. Patient expired following ECMO explant.
CONCLUSIONS: These cases highlight the complex management and complications associated with COVID19 infection requiring VV ECMO support. VV ECMO offers an option to maintain patient’s oxygenation in severe respiratory failure, however, careful patient selection and evidence-based medical management is critical.
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