Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5963
Peer-review started: November 30, 2020
First decision: March 11, 2021
Revised: March 30, 2021
Accepted: May 15, 2021
Article in press: May 15, 2021
Published online: July 26, 2021
A critically ill coronavirus disease 2019 (COVID-19) patient complicated by acute respiratory distress syndrome is reported. The patient survived following treatment with awake veno-venous extracorporeal membrane oxygenation (ECMO).
A 53-year-old male patient attended our hospital following a cough for 11 d and fever for 9 d. According to his computed tomography (CT) scan and real-time reverse transcription–polymerase chain reaction assay of a throat swab, nucleic acid was positive, confirming that he had COVID-19. He was subsequently transferred to the intensive care unit due to respiratory failure. The patient received antiviral drugs, a small dose of glucocorticoid, and respiratory support, including mechanical ventilation, but the treatment effect was poor. On the 28th day after admission, veno-venous ECMO and prone position ventilation (PPV) were performed, combined with awake ECMO and other comprehensive rehabilitation measures. On the 17th day of ECMO, the patient started to improve and his chest CT and lung compliance improved. ECMO was discontinued after 27 days, and mechanical ventilation was also discontinued after 9 days. The patient was then transferred to the rehabilitation department.
COVID-19 can damage lung tissues and cause evident inflammatory exudation, thus affecting oxygenation function. Awake ECMO, PPV, and comprehensive rehabilitation are effective in patients with critical COVID-19 and respiratory failure.
Core Tip: Coronavirus disease 2019 (COVID-19) symptoms include fever, cough, and breathing difficulties. Critically ill patients are often complicated by acute respiratory distress syndrome. Awake extracorporeal membrane oxygenation, prone position ventilation, and comprehensive rehabilitation are effective in patients with critical COVID-19 and respiratory failure.