Extracorporeal Membrane Oxygenation for Critically Ill Patients with COVID-19–related Acute Respiratory Distress Syndrome: Worth the Effort?
Résumé
According to Chinese and Italian reports, 15–42% of patients with coronavirus disease (COVID-19) develop acute respiratory distress syndrome (ARDS), with a 60% mortality rate (1–3). Venovenous extracorporeal membrane oxygenation (VV-ECMO) is therefore considered a rescue therapy to be used in the most severe ARDS, as recommended by the World Health Organization’s interim guidelines for the management of patients with COVID-19 (4). However, without a significant impact on mortality, the benefit of ECMO in ARDS remains controversial (5). Generally, only few data on the use of ECMO in the present pandemic are available (1, 2) with a short follow-up (6, 7). However, accurately selecting patients with COVID-19–related ARDS, who may be good candidates for ECMO support, is important during a pandemic characterized by limited medical resources.