Low fetal age is not a contraindication for extracorporeal membranous oxygenation in COVID‐19‐related ARDS

Abstract

Introduction The coronavirus disease 2019 (COVID‐19) causes a small proportion of patients to be admitted to intensive care units, where they sometimes require extracorporeal membrane oxygenation (ECMO). The literature on pregnant women with COVID‐19 who require ECMO is sparse. Case report We describe here the earliest‐fetal‐age pregnant patient with COVID‐19 who underwent ECMO yet reported, who kept her child while under close follow‐up with magnetic resonance imagery and ultrasound. Conclusion The management of acute respiratory distress syndrome (ARDS) in pregnant women, including ARDS secondary to COVID‐19 and those cases which are not eligible for fetal delivery, may benefit from the assistance of ECMO even in the early pregnancy.

Extracorporeal Membrane Oxygenation in Children With COVID-19: A Systematic Review and Meta-Analysis*

“…We identified 312 articles through the initial database search and the subsequent manual search. After removing 207 items based on the title and abstract, we reviewed the full text of 105 articles and included 44 studies (total number of ECMO use = 110) in the systematic review (8, 9, 11–14, 19–56). In particular, three studies with relatively large sample sizes (number of ECMO use = 42, 31, and 69) were excluded because they did not provide clinical data of patients on ECMO separately (57–59).…”

“…In particular, three studies with relatively large sample sizes (number of ECMO use = 42, 31, and 69) were excluded because they did not provide clinical data of patients on ECMO separately (57–59). Of the 44 articles, 18 were retrospective observational studies (8, 9, 14, 19–33), four were case series (11–13, 34), and 22 were case reports (35–56). Among the total of 22 observational studies and case series, 10 studies included only one ECMO patient (12, 14, 27–34).…”

“…ECMO use details are summarized in Supplemental Table 2 (http://links.lww.com/PCC/C260). The indications for ECMO were specified in 36 studies (8, 9, 11–13, 20–23, 27, 29–31, 33–48, 50–56). The two major indications for ECMO were MIS-C (52% [47/90]) and ARDS (42% [38/90]).…”

“…Among the 31 studies that reported the ECMO mode, 71% (56/79) received venoarterial-ECMO (8, 9, 11–13, 20, 21, 29, 32–41, 44–56). Thirty-four studies reported the ECMO duration; the median days were 7 (interquartile range, 5–13 d), with 71 days being the longest.…”