From the Department of Cardiac Surgery, Pulmonary Hypertension National Referral Center, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Le Plessis Robinson, Paris, France.
Paris-Saclay University School of Medicine, Le Kremlin-Bicêtre, France.
ASAIO J. 2020 Nov/Dec;66(10):1069-1072. doi: 10.1097/MAT.0000000000001251.
Extracorporeal membrane oxygenation (ECMO) is recognized as organ support for potentially reversible acute respiratory distress syndrome (ARDS). However, limited resource during the outbreak and the coagulopathy associated with coronavirus disease 2019 (COVID-19) make the utilization of venovenous (VV) ECMO highly challenging. We herein report specific considerations for cannulation configurations and ECMO management during the pandemic. High blood flow and anticoagulation at higher levels than usual practice for VV ECMO may be required because of thrombotic hematologic profile of COVID-19. Among our first 24 cases (48.8 ± 8.9 years), 17 patients were weaned from ECMO after a mean duration of 19.0 ± 10.1 days and 16 of them have been discharged from ICU.
体外膜肺氧合（ECMO）被认为是潜在可逆转的急性呼吸窘迫综合征（ARDS）的器官支持手段。然而，在疫情期间，资源有限，且与 2019 年冠状病毒病（COVID-19）相关的凝血功能障碍使得静脉-静脉（VV）ECMO 的应用极具挑战性。在此，我们报告了大流行期间置管配置和 ECMO 管理的具体注意事项。由于 COVID-19 的血栓性血液学特征，VV ECMO 可能需要比通常更高的血流量和抗凝水平。在我们的前 24 例病例中（48.8±8.9 岁），17 例患者在平均 19.0±10.1 天的时间后从 ECMO 中脱机，其中 16 例患者从 ICU 出院。
