Extracorporeal membrane oxygenation for COVID-19-related acute respiratory distress syndrome: a narrative review

Journal of Intensive Care

Review

Kollengode Ramanathan¹  Graeme MacLaren¹  Daniel Brodie²  Francesco Alessandri³  Matteo Di Nardo⁴ 

[1] Cardiothoracic Intensive Care Unit, National University Hospital, Singapore, Singapore;Columbia University College of Physicians and Surgeons/New York-Presbyterian Hospital, New York, NY, USA;Center for Acute Respiratory Failure, Columbia University Medical Center, New York, NY, USA;Department of General and Specialistic Surgery, Sapienza University of Rome, Rome, Italy;Pediatric Intensive Care Unit, Children’s Hospital Bambino Gesù, IRCCS, Rome, Italy;

关键词: Extracorporeal membrane oxygenation;    ECMO;    COVID-19;    ARDS;    Respiratory failure;    Extracorporeal life support;   

DOI  :  10.1186/s40560-023-00654-7

 received in 2022-12-19, accepted in 2023-01-30,  发布年份 2023

来源: Springer

【 摘 要 】

A growing body of evidence supports the use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) refractory to maximal medical therapy. ARDS may develop in a proportion of patients hospitalized for coronavirus disease 2019 (COVID-19) and ECMO may be used to manage patients refractory to maximal medical therapy to mitigate the risk of ventilator-induced lung injury and provide lung rest while awaiting recovery. The mortality of COVID-19-related ARDS was variously reassessed during the pandemic. Veno-venous (VV) ECMO was the default choice to manage refractory respiratory failure; however, with concomitant severe right ventricular dysfunction, venoarterial (VA) ECMO or mechanical right ventricular assist devices with extracorporeal gas exchange (Oxy-RVAD) were also considered. ECMO has also been used to manage special populations such as pregnant women, pediatric patients affected by severe forms of COVID-19, and, in cases with persistent and seemingly irreversible respiratory failure, as a bridge to successful lung transplantation. In this narrative review, we outline and summarize the most recent evidence that has emerged on ECMO use in different patient populations with COVID-19-related ARDS.

【 授权许可】

CC BY   
© The Author(s) 2023