Veno‐venous extracorporeal membrane oxygenation and prone ventilation for therapeutic management of COVID‐19

Kasai, Takehiko; Bunya, Naofumi; Wada, Kenshiro; Kakizaki, Ryuichiro; Mizuno, Hirotoshi; Inoue, Hiroyuki; Uemura, Shuji; Takahashi, Satoshi; Narimatsu, Eichi; Takeda, Shinhiro

BACKGROUND: The efficacy and safety of the combined use of veno‐venous extracorporeal membrane oxygenation (ECMO) and prone ventilation are currently not known for coronavirus disease 2019 (COVID‐19). CASE PRESENTATION: We report two cases in which the combination of veno‐venous ECMO and prone ventilation for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pneumonia were successfully carried out. Both patients had developed severe respiratory failure due to SARS‐CoV‐2 pneumonia, thus requiring veno‐venous ECMO. Prone ventilation was also administered safely. CONCLUSION: Oxygenation and lung compliance gradually improved during prone ventilation, and both patients were successfully extubated. For patients with severe SARS‐CoV‐2 pneumonia who require veno‐venous ECMO, the use of prone ventilation could be beneficial, and should be considered.