Extracorporeal membrane oxygenation and COVID‐19: The causes of failure

Ahmadi, Zargham Hossein; Jahangirifard, Alireza; Farzanegan, Behrooz; Tabarsi, Payam; Abtahian, Zahra; Abedini, Atefeh; Sharifi, Mehrzad; Jadbabaei, Amir Naser; Mafhumi, Yadollah; Moslem, Ali; Sistani, Marjan; Yousefian, Sahar; Saffaei, Ali; Dastan, Farzaneh

INTRODUCTION: Venovenous extracorporeal membrane oxygenation (VV‐ECMO) is a therapeutic strategy for the coronavirus disease 2019 (COVID‐19) induced acute respiratory distress syndrome (ARDS). There are inconclusive data in this regard and causes of VV‐ECMO failure are not yet understood well. CASE SERIES: Here, seven patients with COVID‐19‐induced ARDS who underwent VV‐ECMO introduced and causes of VV‐ECMO failure discussed. Medical records of seven COVID‐19 patients treated with VV‐ECMO were retrospectively evaluated to determine the clinical outcomes of VV‐ECMO. Oxygenator failure occurred in four patients whom needed to oxygenator replacement. Successful VV‐ECMO decannulation was done in three patients, however finally one patient survived. CONCLUSIONS: Hypercoagulability state and oxygenator failure were the most main etiologies for VV‐ECMO failure in our study. All patients with COVID‐19 undergoing VV‐ECMO should be monitored for such problems and highly specialized healthcare team should monitor the patients during VV‐ECMO.