COVID-19 ECMO Myths Busted

Abstract

Literature has proven that COVID-19 patients develop pneumonia. Prognosis of this is poor in case of COVID-19 patients developing the following: low lymphocyte count (< 16%) which gets lower with active COVID-19 infection, sedentary lifestyle, obesity, and uncontrolled diabetes mellitus with no exercise. A lot of dilemmas and myths in this nascent COVID-19 pandemic period exist regarding the use of ECMO. Perplexities such as do we treat the COVID-19 patients on ECMO, as a pulmonary ARDS pneumonia, and/or do we need high PEEP or moderate PEEP, during ECMO for this ARDS; are some common COVID-19 ECMO myths which this short review aims to cover in a question-answer format.

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“…Time and experience will be narrative! 7 Sedation analgesia for diagnostic/therapeutic procedures should be adopted. Adequate sedation should be extended in cardiac practice also in the cath laboratory for monitored anaesthesia care, percutaneous procedures for device insertion and all hybrid procedures in operating room and MRI suites and also in intensive medication for sedation and analgesia, outside the operating room.…”

TIVA for ECMO and VAD

“…Do we manage patients with a wet or dry circuit for mucus plugging and whether secretion management time and experience will be narrative? 16…”

COVID-19 Thrombosis: An Unsolved Mystery

“…In addition, treatment with glucocorticosteroids may cause lymphocytopenia in some cases. 10 Support with extracorporeal membrane oxygenation (ECMO) is further not available in many low-and middle-income countries; therefore, ECMO might not seem to gain as much of a priority as personal protective equipment, correct management, diagnosis and quarantine, oxygen therapy alone, and mechanical ventilation in the first instance.…”