Veno-venous extracorporeal membrane oxygenation in acute respiratory distress syndrome in patients with COVID-19: case series

S.R. Marunyak, O.M. Druzhyna, O.A. Loskutov, S.M. Sudakevych, I.M. Kuzmych, I.V. Galamai, R.V. Kyreychykova, N.V. Korotchuk, O.V. Adamenko, M.A. Taranov, V.B. Demyanchuk, B.M. Todurov

Heart Institute, Ministry of Healthcare of Ukraine, Kyiv, Ukraine

The aim – to analyze the therapeutic efficacy of veno-venousextracorporeal membrane oxygenation(ECMO) in patients with acute respiratory distress syndrome (ARDS) caused by SARS-CoV-2.

Materials and methods. A retrospective analysis of patients with acute lung injury because of COVID-19, receiving veno-venous ECMO treatment from February 2020 to May 2021, was carried out.

Results. During thе period of the study, seven cases of veno-venous ECMO connection due to ARDS were recorded. Clinically they fell under the manifestations of COVID-19 infection. The most frequent complication during ECMO was thrombosis in the ECMO system – 42.9 %, which required replacement of the oxygenator – in two cases and replacement of the ЕСМО-system – in one case. Three patients had bleeding at the cannulation site in combination with epistaxis or gastrointestinal bleeding. In general, the mortality rate for ECMO among the examined patients was 57.1 %, while the 30-day mortality rate was 71.4 %.

Conclusions. Early consultation with ECMO center is a key strategy in the effective treatment of patients with COVID-19 with severe respiratory failure. However, the criteria for selecting such patients for ECMO, as well as the optimal strategy for anticoagulation therapy, remain unclear.

Key words: extracorporeal membrane oxygenation, acute respiratory distress syndrome, СOVID-19.

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