Extracorporeal Membrane Oxygenation and Prone Position Ventilation on Critically ill COVID-19: A Case Report and Literature Review
Background: COVID-19 broke out all over the world, and the mortality rate is extremely high. We report the successful experience of a critically ill COVID-19 patient who underwent long-term extracorporeal membrane oxygenation (ECMO) and multiple prone position ventilation (PPV) treatments.
Case presentation: A 53-year-old male patient was sent to our hospital after 11 days of cough and 9 days of fever. According to his CT scan and real-time reverse transcription–polymerase chain reaction assay to throat swap, his nucleic acid was positive, confirming that he was infected with COVID-19. Subsequently, he was sent to ICU for respiratory failure. Afterwards, the patient received antiviral drug, tiny amount of glucocorticoid, and respiratory support, including mechanical ventilation, but the affect was poor. In the 28th day of his admission, veno-venous ECMO and PPV were used, combining with awake ECMO and other comprehensive rehabilitation. In the 17th day of ECMO, the patient started getting better and his chest CT and lung compliance improved. The ECMO was removed in the 27th days, after which the mechanical ventilation was gotten rid of in the 9th day. Then he was transferred to rehabilitation department.
Conclusions: COVID-19 can damage lung tissues and cause evident inflammatory exudation, affecting oxygenation function. It is effective to use PPV, awake ECMO, and comprehensive rehabilitation to cure patients with critical COVID-19 and respiratory failure. Our experience hopes to be promoted to play a positive role.
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Posted 05 Jun, 2020
Extracorporeal Membrane Oxygenation and Prone Position Ventilation on Critically ill COVID-19: A Case Report and Literature Review
Posted 05 Jun, 2020
Background: COVID-19 broke out all over the world, and the mortality rate is extremely high. We report the successful experience of a critically ill COVID-19 patient who underwent long-term extracorporeal membrane oxygenation (ECMO) and multiple prone position ventilation (PPV) treatments.
Case presentation: A 53-year-old male patient was sent to our hospital after 11 days of cough and 9 days of fever. According to his CT scan and real-time reverse transcription–polymerase chain reaction assay to throat swap, his nucleic acid was positive, confirming that he was infected with COVID-19. Subsequently, he was sent to ICU for respiratory failure. Afterwards, the patient received antiviral drug, tiny amount of glucocorticoid, and respiratory support, including mechanical ventilation, but the affect was poor. In the 28th day of his admission, veno-venous ECMO and PPV were used, combining with awake ECMO and other comprehensive rehabilitation. In the 17th day of ECMO, the patient started getting better and his chest CT and lung compliance improved. The ECMO was removed in the 27th days, after which the mechanical ventilation was gotten rid of in the 9th day. Then he was transferred to rehabilitation department.
Conclusions: COVID-19 can damage lung tissues and cause evident inflammatory exudation, affecting oxygenation function. It is effective to use PPV, awake ECMO, and comprehensive rehabilitation to cure patients with critical COVID-19 and respiratory failure. Our experience hopes to be promoted to play a positive role.
Figure 1
Figure 2
Figure 3