Extracorporeal membrane oxygenation (ECMO) machine in a ICU patient in Santa Cruz Hospital, Lisbon, Portugalj - Wikipedia
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An update from the Centre Hospitalier Regionale et Universitaire de Lille, in France where two nCoV patients remain in their ICU; the index case who traveled to the UAE during the middle of April, and a second patient who shared a hospital room with him before he was diagnosed.
Checkup of the two patients coronavirus
14 May 2013 - 12
Both patients coronavirus ICU at University Hospital of Lille are still in a poor state of health.
The first patient remains in stable condition. No improvement is recognized by doctors for the moment.
The second patient is still under ventilatory support by ventilator.
His condition is not completely stabilized.
The index case – a 65 y.o. man who was hospitalized on April 23rd - reportedly remains on an ECMO (Extracorporeal Membrane Oxygenation) machine. Increasingly, we’ve seen ECMO support used for severe respiratory distress due to pneumonia, avian flu, and the novel coronavirus.
Normally patients with Acute Respiratory Distress Syndrome (ARDS) are placed on a mechanical ventilator and treated with a variety of drugs to reduce infection (antibiotics) and lung inflammation (corticosteroids, Nitric Oxide, etc.).
Despite these measures, ARDS is generally fatal in 50% of patients.
Which is why in 2009 some hospitals tried an expensive and controversial treatment called ECMO on some adult and adolescent patients with H1N1 related pneumonia, and early reports were encouraging.
ECMO is a specialized heart-lung bypass machine used to take over the body’s heart and lung function – for days or weeks if necessary – while the body heals from injury or illness.
ECMO is most commonly used in neonatal intensive care units for newborns in respiratory distress, although it is also used for pediatric and adult patients with severe heart or respiratory deficits.
In the fall of 2009 we saw a report in The Lancet where UK researchers determined that ARF (Adult Respiratory Failure) patients that received ECMO support as opposed to conventional ventilation had a greater survivability without disability.
While often lifesaving, ECMO resources are extremely limited, and are simply not available in many regions of the world.
For more on ECMO, and how it has been used for ARDS, you may wish to revisit.
JAMA: H1N1, ECMO, and Survivability
The ECMO Option
