Authors: Abrams D, Lorusso R, Vincent JL, Brodie D
PMID: 32807189 PMCID: PMC7429936 DOI: 10.1186/s13054-020-03230-9
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to a critical shortage of resources in the hardest-hit areas around the world. Intensive care units (ICUs) overwhelmed by critically ill patients may create non-conventional ICU spaces and even consider triaging invasive mechanical ventilation to those most likely to benefit. In the most severe cases of refractory hypoxemia, extracorporeal membrane oxygenation (ECMO) may be considered, as recommended by the World Health Organization for severe COVID-19. Early data suggest there may be a benefit from ECMO in certain patients with COVID-19-associated respiratory failure, though outcomes are likely to be highly dependent on patient selection and timing of ECMO initiation. Whether certain phenotypes of COVID-19 (if present) have differential responses to and prognoses with ECMO remains to be determined. An important question then is whether a resource-intensive therapy is warranted when systems are already strained.
Keywords: ECMO, COVID-19
