Continuous venous hemodialysis integrated to the ECMO circuit in critically ill patient with COVID-19, a case report in Morocco

Pan Afr Med J. 2020 Aug 10;35(Suppl 2):141. doi: 10.11604/pamj.supp.2020.35.141.25332. eCollection 2020.

Abstract

Novel coronavirus 2019 (COVID-19) is a severe respiratory infection leading to acute respiratory distress syndrome [ARDS] accounting for thousands of cases and deaths across the world. Several alternatives in treatment options have been assessed and used in this patient population. However, when mechanical ventilation and prone positioning are unsuccessful, venovenous extracorporeal membrane oxygenation [VV-ECMO] may be used. We present a case of a 62-year-old female, diabetic, admitted to the intensive care unit with fever, flu-like symptoms and a positive COVID-19 test. Ultimately, she worsened on mechanical ventilation and prone positioning and required VV-ECMO. The use of VV-ECMO in COVID-19 infected patients is still controversial. While some studies have shown a high mortality rate despite aggressive treatment, such as in our case, the lack of large sample size studies and treatment alternatives places healthcare providers against a wall without options in patients with severe refractory ARDS due to COVID-19.

Keywords: ARDS; COVID-19; ECMO; hemodialysis.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / therapy
  • Anti-Bacterial Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Bacteremia / complications
  • Betacoronavirus*
  • COVID-19
  • Combined Modality Therapy
  • Continuous Renal Replacement Therapy / instrumentation
  • Continuous Renal Replacement Therapy / methods*
  • Coronavirus Infections / complications*
  • Coronavirus Infections / drug therapy
  • Critical Illness* / therapy
  • Cytokine Release Syndrome / etiology
  • Diabetes Mellitus, Type 2 / complications
  • Extracorporeal Membrane Oxygenation / instrumentation*
  • Fatal Outcome
  • Female
  • Gram-Positive Bacterial Infections / complications
  • Humans
  • Middle Aged
  • Morocco
  • Pandemics
  • Pneumonia, Viral / complications*
  • Respiration, Artificial
  • Respiratory Distress Syndrome / etiology
  • SARS-CoV-2

Substances

  • Anti-Bacterial Agents
  • Antiviral Agents

Supplementary concepts

  • COVID-19 drug treatment