Case Report: Respiratory Management With a 47-Day ECMO Support for a Critical Patient With COVID-19

Wen Xu; Ruoming Tan; Jie Huang; Shuai Qin; Jing Wu; Yuzhen Qiu; Simin Xie; Yan Xu; Ying Du; Feng Li; Bailing Li; Yingchuan Li; Yuan Gao; Xin Li; Hongping Qu

doi:10.3389/fmed.2021.714387

Frontiers in Medicine (Dec 2021)

Case Report: Respiratory Management With a 47-Day ECMO Support for a Critical Patient With COVID-19

Wen Xu,
Ruoming Tan,
Jie Huang,
Shuai Qin,
Jing Wu,
Yuzhen Qiu,
Simin Xie,
Yan Xu,
Ying Du,
Feng Li,
Bailing Li,
Yingchuan Li,
Yuan Gao,
Xin Li,
Hongping Qu

Affiliations

Wen Xu: Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Ruoming Tan: Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Jie Huang: Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Shuai Qin: Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Jing Wu: Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Yuzhen Qiu: Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Simin Xie: Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Yan Xu: Department of Critical Care Medicine, Ruijin Hospital North, Shanghai Jiaotong University School of Medicine, Shanghai, China
Ying Du: Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Feng Li: Intensive Care Unit, Shanghai Public Health Clinical Center, Shanghai, China
Bailing Li: Department of Cardiovascular Surgical Intensive Care Unit (ICU), Changhai Hospital, Shanghai, China
Yingchuan Li: Department of Critical Care Medicine, The Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China
Yuan Gao: Department of Critical Care Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Xin Li: Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
Hongping Qu: Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

DOI: https://doi.org/10.3389/fmed.2021.714387
Journal volume & issue: Vol. 8

Abstract

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This paper reports a complete case of severe acute respiratory distress syndrome (ARDS) caused by coronavirus disease 2019 (COVID-19), who presented with rapid deterioration of oxygenation during hospitalization despite escalating high-flow nasal cannulation to invasive mechanical ventilation. After inefficacy with lung-protective ventilation, positive end-expiratory pressure (PEEP) titration, prone position, we administered extracorporeal membrane oxygenation (ECMO) as a salvage respiratory support with ultra-protective ventilation for 47 days and finally discharged the patient home with a good quality of life with a Barthel Index Score of 100 after 76 days of hospitalization. The purpose of this paper is to provide a clinical reference for the management of ECMO and respiratory strategy of critical patients with COVID-19-related ARDS.

Published in Frontiers in Medicine

ISSN: 2296-858X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Medicine (General)
Website: http://www.frontiersin.org/journals/medicine

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