From the Houston Heart, HCA Houston Healthcare, Houston, Texas.
Department of Clinical Sciences, University of Houston College of Medicine, Houston, Texas.
ASAIO J. 2021 Apr 1;67(4):392-394. doi: 10.1097/MAT.0000000000001393.
A subset of patients with coronavirus disease 2019 (COVID-19) develop profound respiratory failure and are treated via invasive mechanical ventilation (IMV). Of these, a smaller subset has severe gas exchange abnormalities that are refractory to maximal levels of IMV support. Extracorporeal membrane oxygenation (ECMO) has been used successfully in these circumstances. However, using ECMO only after failure of IMV exposes patients to the risks of ventilator-induced lung injury. We report a successful outcome using ECMO in the setting of COVID-19 in the absence of IMV failure in an awake, nonintubated patient. This approach may be beneficial for selected patients with COVID-19.
一部分 2019 冠状病毒病（COVID-19）患者会出现严重呼吸衰竭，并通过有创机械通气（IMV）进行治疗。其中，一小部分患者的气体交换严重异常，对最大水平的 IMV 支持具有抵抗力。体外膜氧合（ECMO）已在这些情况下成功应用。然而，仅在 IMV 失败后使用 ECMO 会使患者面临呼吸机引起的肺损伤的风险。我们报告了在清醒、未插管的 COVID-19 患者中，在没有 IMV 失败的情况下成功使用 ECMO 的结果。这种方法可能对某些 COVID-19 患者有益。
