COVID-19 patient bridged to recovery with veno-venous extracorporeal membrane oxygenation.
COVID-19 patient bridged to recovery with veno-venous extracorporeal membrane oxygenation.
复制标题
COVID-19 患者通过静脉-静脉体外膜氧合过渡到康复。
DOI：
10.1111/jocs.14829
复制
发表时间：
2020
影响因子：
1.6
通讯作者：
Mallidi,HariR
中科院分区：
文献类型：
--
作者：
Rinewalt,Daniel;Coppolino,Anthony;Seethala,Raghu;Sharma,Nirmal;Salim,Ali;Keller,Steve;Mallidi,HariR
背景在重症病例中，冠状病毒病2019(新冠肺炎)病毒病原体会产生缺氧性呼吸衰竭，无法通过机械通气得到充分支持。体外膜氧合的作用目前尚不清楚，到目前为止，很少有出版物缺乏详细的患者信息或管理算法，同时都报告了过高的死亡率。方法来自前瞻性维护的机构COVID-19体外膜氧合数据库的病例报告。结果我们描述了一例新冠肺炎阳性女性缺氧性呼吸功能障碍患者，在俯卧接受吸入性肺血管扩张剂治疗时，静脉-静脉(VV)体外膜氧合治疗失败。经过9天的高动力循环支持治疗，患者顺利脱离仰卧式机械通气，最终出院。结论选择合适的患者，重视血液动力学管理，仍是新冠肺炎患者合理的治疗方案。
BackgroundIn 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.MethodsCase report from a prospectively maintained institutional ECMO database for COVID‐19.ResultsWe 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.ConclusionsWith proper patient selection and careful attention to hemodynamic management, ECMO remains a reasonable treatment option for patients with COVID‐19.