Outcomes of COVID-19 patients on ECMO in intensive care unit: A case series

Tóm tắt

Background

In the intensive care unit (ICU), patients with Coronavirus disease 2019(COVID-19) developed acute hypoxemic respiratory failure of varying severity and its incidence can be as high as 67%. According to the World Health Organization (WHO), one of the components of COVID-19 management is supportive care. Extracorporeal membrane oxygenation (ECMO) is part of the supportive care available in our healthcare setting.

Methods

This is a retrospective study that involved patients who had COVID-19 infection and were supported by ECMO, admitted to our National Isolation Center (NIC) ICU, Brunei Darussalam from August 2021 until January 2022 .

Results

Total of 12 patients, one of which had to be excluded in view of mortality within 24 hours of initiation of ECMO. Overall mortality was 82%. Mean age was 41.7 +/- 10.1 years old. There were two survivors who were tracheostomized and eventually decannulated. One patient was fully vaccinated. 45% of patients had hypertension, 54% of patients had diabetes Mellitus and 18% were morbidly obese. 10 patients had percentage more than 76% based on the Respiratory ECMO Survival Prediction (RESP) score but only survived. High-resolution computerized tomography (HRCT) scanning was only performed on two patients to assess the extension of lung damage.

Conclusion

Based on the cases reviewed, we concluded that using scoring system like RESP score will not be accurate in predicting survival in COVID-19 patients. We also concluded the importance of HRCT scanning of the lungs to assess the extension of lung damage before the initiation of ECMO and its potential value in the prognostication following ECMO initiation.