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.