Fitzgerald Amelia Lucy, Vachharajani Hemal Hitesh, Davidson Benjamin Paul, Kruit Natalie Joanne, Eslick Adam Trevor
Westmead Hospital, Westmead, Sydney, New South Wales, Australia.
Faculty of Medicine, University of Sydney, New South Wales, Sydney Australia.
J Crit Care Med (Targu Mures). 2020 Nov 7;6(4):224-230. doi: 10.2478/jccm-2020-0034. eCollection 2020 Oct.
COVID-19 has resulted in unprecedented global health and economic challenges. The reported mortality in patients with COVID-19 requiring mechanical ventilation is high. VV ECMO may serve as a lifesaving rescue therapy for a minority of patients with COVID-19; however, its impact on overall survival of these patients is unknown. To date, few reports describe successful discharge from ECMO in COVID-19 after a prolonged ECMO run. The only Australian case of a COVID-19 patient, supported by prolonged VV ECMO in conjunction with prone ventilation, complicated by significant airway bleeding, and successfully decannulated after forty-two days, is described. VV ECMO is a resource-intense form of respiratory support. Providing complex therapies such as VV ECMO during a pandemic has its unique challenges. This case report provides a unique insight into the potential clinical sequelae of COVID-19, supported in an intensive care environment which was not resource-limited at the time, and adds to the evolving experience of prolonged VV ECMO support for ARDS with a goal to lung recovery.
新型冠状病毒肺炎（COVID-19）带来了前所未有的全球健康和经济挑战。据报道，需要机械通气的COVID-19患者死亡率很高。体外膜肺氧合（VV ECMO）可能作为少数COVID-19患者的救命抢救治疗手段；然而，其对这些患者总体生存率的影响尚不清楚。迄今为止，很少有报告描述COVID-19患者在长时间使用ECMO后成功脱机出院的情况。本文描述了澳大利亚唯一一例COVID-19患者，该患者在长时间VV ECMO支持并结合俯卧位通气的情况下，出现严重气道出血并发症，四十二天后成功拔管。VV ECMO是一种资源密集型的呼吸支持形式。在大流行期间提供诸如VV ECMO等复杂治疗有其独特的挑战。本病例报告为COVID-19在非资源受限的重症监护环境下可能出现的临床后遗症提供了独特见解，并为以肺康复为目标的ARDS患者长时间VV ECMO支持的不断发展的经验增添了内容。
