Severe cases of coronavirus disease 2019 (COVID-19) cannot be adequately managed with mechanical ventilation alone. The role and outcome of extracorporeal membrane oxygenation (ECMO) in the management of COVID-19 is currently unclear. Eight COVID-19 patients have received ECMO support in Shanghai with 7 with VV ECMO support and 1 VA ECMO during cardiopulmonary resuscitation. As of March 25, 2020, 4 patients died (50% mortality), three patients (37.5%) were successfully weaned off ECMO after 22, 40 days and 47 days support respectively, but remain on mechanical ventilation. One patient is still on VV ECMO with mechanical ventilation. The PaO2/FiO2 ratio before ECMO initiation were between 54 to 76 and all were well below 100. The duration of mechanical ventilation before ECMO ranged from 4-21 days. Except the one emergent VA ECMO during cardiopulmonary resuscitation, other patients were on ECMO support for between 18 to 47 days. In conclusion, ensuring effective, timely, and safe ECMO support in COVID-19 is key to improving clinical outcomes. ECMO support might be an integral part of the critical care provided for COVID-19 patients in centers with advanced ECMO expertise.
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