Extracorporeal membrane oxygenation support in 2019 novel coronavirus disease: indications timing and implementation

摘要

The 2019 novel coronavirus disease (COVID-19) has spread rapidly across Hubei province and to all regions in China owing to its person-to-person transmission and strong invasiveness targeting the lower respiratory tract. By the end of February 15, 2020, more than 68,000 cases of COVID-19 pneumonia had been confirmed in China, including over 1600 fatalities. Most infected patients who developed COVID-19 pneumonia suffered from only mild symptoms and then completely recovered. However, in some patients, the phenotype may rapidly progress to acute respiratory distress syndrome (ARDS) and multi-organ failure. The initial clinical data, collected in Wuhan Jinyintan Hospital, showed that ARDS was reported in 12 (29%) among 41 confirmed patients. Among the 41 patients, 13 patients received medical care in the intensive care unit (ICU), 4 patients were provided invasive mechanical ventilations, whereas for two patients, extracorporeal membrane oxygenation (ECMO) treatment was applied. Finally, six of the 41 patients died. The clinical data of 99 confirmed patients from the same hospital demonstrated that 17 in 99 patients developed ARDS; among them, three received ECMO treatment, and 11 died. Another study reported that 22 in 138 cases (16%) developed into ARDS and were admitted into the ICU, of which four received ECMO.