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COVID-19 Respiratory Failure: Targeting Inflammation on VV-ECMO Support
Matthew E Hartman1,2, Roland A Hernandez3, Krish Patel4
1From the Division of Cardiology, Swedish Medical Center.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|April 19, 2020
Summary
This case study highlights a young patient
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Pulmonology
Background:
- The novel coronavirus (SARS-CoV-2) causing COVID-19 presents a global health crisis with high mortality and limited treatment options.
- Severe COVID-19 can lead to rapid respiratory decompensation and multiorgan failure, necessitating advanced life support.
- Hyperinflammation, characterized by elevated C-reactive protein and cytokines like Interleukin-6, is a hallmark of critical COVID-19.
Observation:
- A young patient presented with life-threatening COVID-19, progressing to profound respiratory decompensation.
- The patient exhibited hyperinflammation with significantly elevated C-reactive protein and Interleukin-6 levels.
- Venovenous extracorporeal membrane oxygenation (VV-ECMO) was initiated due to critical respiratory failure.
Findings:
- Targeted anti-inflammatory treatment led to recovery from critical COVID-19 respiratory failure.
- The patient required 160 hours of VV-ECMO support, followed by successful extubation and renal recovery.
- This represents one of the first successful VV-ECMO cases for COVID-19 respiratory failure in North America.
Implications:
- VV-ECMO can be a life-saving intervention for select patients with severe COVID-19 ARDS.
- Management of hyperinflammation is crucial for improving outcomes in critical COVID-19.
- This case underscores the importance of advanced life support in managing novel infectious disease outbreaks.
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