Extracorporeal membrane Oxygenation and COVID-19

Abstract

ECMO (ExtraCorporeal Membrane Oxygenation) is still a "rescue" therapy for both hemodynamic and respiratory support. Its use is relatively low and is restricted to specialized centers. The WHO declared as pandemic the severe acute respiratory syndrome due to coronavirus 2 (SARS-CoV-2) causing fatal pneumonia due to coronavirus 19 disease (COVID-19). Although the new coronavirus has a low lethality compared to other epidemics, its diffusion capacity is phenomenal. When ECMO therapy is indicated, its initiation in a specialized ECMO center should not be delayed. HEALTH WORKERS ARE OF HIGH PRIORITY. VA or VAV support may be indicated. In Mexico, we have even considered activating the logistics of obtaining an ECMO team since the patient presents with PaO2/FiO2 of 100 mmHg or when it is indicated to pronate the patient. The early use and early activation of an ECMO team will undoubtedly give better results than the late application of this therapy. Direct myocardial involvement due to this virus has been reported causing myocarditis and acute coronary events, so it may be worth leaving a femoral artery vascular introducer so that if necessary, the patient can be supported with VA ECMO or VAV ECMO. These measures may lead to improved prognosis and outcome for patients affected by COVID-19.