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 cmH 2 O and a positive end-expiratory pressure (PEEP) of ≤ 10 cmH 2 O, 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.
【저자키워드】 COVID-19, acute respiratory distress syndrome, venovenous extracorporeal membrane oxygenation, ultra-protective ventilation, 【초록키워드】 ARDS, therapy, Prognosis, mechanical ventilation, VV-ECMO, Ventilation, China, extracorporeal membrane oxygenation, implementation, Gas exchange, Wuhan, Patient, mortality rate, disease, acute respiratory distress, COVID-19 patient, PEEP, Ventilator-induced lung injury, Positive end-expiratory pressure, syndrome, caused, involved, reported, applied, provide, receive, 【제목키워드】 respiratory, Extracorporeal, report,