Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2021; 9(21): 5963-5971
Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5963
Awake extracorporeal membrane oxygenation support for a critically ill COVID-19 patient: A case report
Jing-Chen Zhang, Tong Li
Jing-Chen Zhang, Tong Li, Department of Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Zhang JC generated the idea of the case report and was the consultant in charge of the patient, reviewed the patient’s case notes and wrote the original draft of the case presentation; Li T significantly revised the original draft and added the conclusions and references; all authors contributed to the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tong Li, MD, Research Associate, Department of Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. drli@zju.edu.cn
Received: November 30, 2020
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
Abstract
BACKGROUND

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).

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: COVID-19, Awake extracorporeal membrane oxygenation, Prone position ventilation, Rehabilitation, Case report

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.