Extracorporeal membrane oxygenation and COVID-19: The causes of failure

J Card Surg. 2020 Oct;35(10):2838-2843. doi: 10.1111/jocs.14867. Epub 2020 Jul 17.

Abstract

Introduction: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a therapeutic strategy for the coronavirus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS). There are inconclusive data in this regard and causes of VV-ECMO failure are not yet understood well.

Case series: Here, seven patients with COVID-19-induced ARDS who underwent VV-ECMO introduced and causes of VV-ECMO failure discussed. Medical records of seven COVID-19 patients treated with VV-ECMO were retrospectively evaluated to determine the clinical outcomes of VV-ECMO. Oxygenator failure occurred in four patients whom needed to oxygenator replacement. Successful VV-ECMO decannulation was done in three patients, however finally one patient survived.

Conclusions: Hypercoagulability state and oxygenator failure were the most main etiologies for VV-ECMO failure in our study. All patients with COVID-19 undergoing VV-ECMO should be monitored for such problems and highly specialized healthcare team should monitor the patients during VV-ECMO.

Keywords: SARS coronavirus; SARS-CoV infection; acute respiratory distress syndrome; extracorporeal membrane oxygenation; hypercoagulability.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / complications
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / therapy*
  • Extracorporeal Membrane Oxygenation / adverse effects*
  • Humans
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / therapy*
  • Respiratory Distress Syndrome / etiology
  • Respiratory Distress Syndrome / therapy*
  • Retrospective Studies
  • SARS-CoV-2
  • Treatment Failure