ECMO/CRRT Combined Support in the Treatment of Critically Ill SARS-CoV-2 Pneumonia Patients

• 作者: Hai Zou Shengqing Li
• 来源期刊: Cardiovascular Innovations and Applications
• 学科: 医学
• 关键词: Extracorporeal membrane oxygenation continuous renal replacement therapy critically ill SARS-CoV-2 pneumonia patients
• 年，卷（期）: 2021,（1）
• 页码范围: 183-192
• 页数: 10页
• 分类号: R47

摘要

Objective: To explore the experience with and complications of extracorporeal membrane oxygenation (ECMO)combined with continuous renal replacement therapy (CRRT) for treatment of critically ill patients with severe acuterespiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia.Methods: The data on critically ill COVID-19 patients who received ECMO/CRRT at Tongji Hospital, which isaffi liated with Huazhong University of Science and Technology, in February and March 2020 were collected andanalyzed. All three patients were male, and the mean age was 50.6 years (range 44 – 58 years). The indications forECMO in critically ill SARS-CoV-2 pneumonia patients at our center were severe acute respiratory distress syndromewith Pa o 2 /F i o 2 below 100 mmHg under an effective protective pulmonary ventilation strategy and infl ammatory stormaccompanied by acute kidney injury. One patient, with severe heart failure, was selected for venoarterial ECMO, andthe other two patients were selected for venovenous ECMO.Results: In the three patients who received ECMO combined with bedside CRRT, the mean duration was 9.7 days(range 7 – 13 days). Four complications occurred during ECMO/CRRT, especially thrombocytopenia. Laboratorytesting showed increased counts of leukocytes and lymphocytes and decreased levels of infl ammatory factors. LungCT was suggestive of signifi cantly absorbed and reduced lesions and interstitial fi brosis.Conclusions: The survival rate of patients with cardiopulmonary failure treated with ECMO/CRRT in whomconventional treatment failed in this group was 100%, which indicates that combined treatment with ECMO and CRRTis an important treatment technique.