Introduction
Since its outbreak in 2019, there have been over 50 million cases of
coronavirus disease 2019 (COVID-19) and 1.25 million recorded deaths.(1)
While most patients experience mild to moderate symptoms, COVID-19 can
progress to acute respiratory distress syndrome (ARDS), a rapidly
progressive inflammatory syndrome that impairs oxygen transport in the
lungs.(2,3) The pulmonary injury in ARDS due to COVID-19 has been shown
to resemble ARDS unrelated to COVID-19, and even with mechanical
support, ARDS is associated with a significant mortality among COVID-19
patients.(2,4,5)
The high mortality rate of ARDS due to COVID-19 increased the demand for
other treatment options, and the use of extracorporeal membrane
oxygenation (ECMO) was encouraged for select cases of refractory ARDS
with severe hypoxemia.(5–8) ECMO is a temporary form of mechanical
cardiopulmonary support for patients with severe cardiac and/or
respiratory shock. First clinically used in 1972, ECMO’s use has
exponentially increased in the past two decades.(9–11) While its
efficacy in lowering mortality rates is still debated, ECMO is now a
common treatment for patients with refractory ARDS.(11–14)
Despite some recent publications,(15–17) there remains a lack of
evidence documenting the overall efficacy of ECMO in treating ARDS due
to COVID-19. The purpose of this paper is to share our experience using
ECMO as a bridge to recovery for patients with ARDS due to COVID-19
during the first wave of the COVID-19 pandemic in our area.