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Medicina (Kaunas) ; 56(11)2020 Oct 29.
Статья в английский | MEDLINE | ID: covidwho-902594

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Coronavirus disease (COVID-19) started in Wuhan (China) at the end of 2019, and then increased rapidly. In patients with severe acute respiratory distress syndrome (ARDS) caused by COVID-19, venovenous extracorporeal membrane oxygenation (VV-ECMO) is considered a rescue therapy that provides adequate gas exchange. The way in which mechanical ventilation is applied during VV-ECMO is not clear, however it is associated with prognosis. Currently, the mortality rate of COVID-19 patients that receive VV-ECMO stands at approximately 50%. Here, we report three patients that successfully recovered from COVID-19-induced ARDS after VV-ECMO and implementation of an ultra-protective ventilation. This ventilation strategy involved maintaining a peak inspiratory pressure of ≤20 cmH2O and a positive end-expiratory pressure (PEEP) of ≤ 10 cmH2O, which are lower values than have been previously reported. Thus, we suggest that this ultra-protective ventilation be considered during VV-ECMO as it minimizes the ventilator-induced lung injury.


Тема - темы
Coronavirus Infections/therapy , Extracorporeal Membrane Oxygenation/methods , Glucocorticoids/therapeutic use , Pneumonia, Viral/therapy , Respiration, Artificial/methods , Respiratory Distress Syndrome/therapy , Ventilator-Induced Lung Injury/prevention & control , Aged , Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , Betacoronavirus , COVID-19 , Coronavirus Infections/drug therapy , Female , Humans , Immunization, Passive , Male , Middle Aged , Pandemics , SARS-CoV-2 , COVID-19 Drug Treatment , COVID-19 Serotherapy
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