Bakkehaug Jens Petter, Kåsine Trine, Romundstad Luis, Narum Jon, Laake Jon Henrik, Svalebjørg Morten, Fiane Arnt Eltvedt, Hoel Tom, Thiara Amrit, Pischke Søren Erik, Aasmundstad Tor Aksel, Barratt-Due Andreas
Intensivavdelingen, Akuttklinikken, Oslo universitetssykehus, Rikshospitalet.
Thoraxkirurgisk avdeling, Oslo universitetssykehus, Rikshospitalet.
Tidsskr Nor Laegeforen. 2023 Jan 30;143(2). doi: 10.4045/tidsskr.22.0545. Print 2023 Jan 31.
COVID-19 can lead to acute respiratory distress syndrome (ARDS). In some patients for whom conventional mechanical ventilation is insufficient, venovenous (VV) extracorporeal membrane oxygenation (ECMO) can be life-saving.
Retrospective analysis of data from patients with ARDS triggered by COVID-19 who received ECMO therapy between March 2020 and February 2022. Premorbid health condition, course of respiratory distress and respiratory support before, during and after ECMO therapy were registered.
Thirty patients received ECMO therapy. Median age was 57 years, median body mass index 28 kg/m2, and 23 patients were men. Median duration of lung protective mechanical ventilation with tidal volume 5.8 mL/kg predicted body weight before initiation of ECMO therapy was 8 days. Treatment indication was primarily severe hypoxaemia, frequently combined with hypercapnia. Twenty-three patients developed at least one severe complication while receiving ECMO therapy. Sixteen patients died, 13 during ongoing ECMO therapy. Fourteen were discharged from hospital. Median duration of ECMO and mechanical ventilation was 27 and 37 days, respectively.
ECMO therapy for patients with ARDS triggered by COVID-19 can be life-saving, but the treatment is accompanied by severe complications and a high mortality rate.
新型冠状病毒肺炎（COVID-19）可导致急性呼吸窘迫综合征（ARDS）。对于一些常规机械通气不足的患者，静脉-静脉（VV）体外膜肺氧合（ECMO）可挽救生命。
回顾性分析2020年3月至2022年2月期间接受ECMO治疗的COVID-19引发的ARDS患者的数据。记录病前健康状况、呼吸窘迫病程以及ECMO治疗前、治疗期间和治疗后的呼吸支持情况。
30例患者接受了ECMO治疗。中位年龄为57岁，中位体重指数为28kg/m²，23例为男性。在开始ECMO治疗前，采用潮气量为5.8mL/kg预计体重的肺保护性机械通气的中位持续时间为8天。治疗指征主要是严重低氧血症，常伴有高碳酸血症。23例患者在接受ECMO治疗期间至少出现一种严重并发症。16例患者死亡，13例在ECMO治疗期间死亡。14例患者出院。ECMO和机械通气的中位持续时间分别为27天和37天。
COVID-19引发的ARDS患者接受ECMO治疗可挽救生命，但该治疗伴有严重并发症和高死亡率。
