PDF(Pubmed)
Abstract：
The reported case is of a 68-year-old man who was admitted to the ICU at our tertiary care medical center with severe COVID-19. He was admitted to the ICU due to a worsening respiratory condition during his hospitalization at the same medical center, which included the development of severe acute respiratory distress syndrome (ARDS). Ventilator management was started with alveolar protection in mind. On the ninth day of ventilator management, we judged that it was necessary to introduce extracorporeal membrane oxygenation (ECMO). Although the ninth day of ventilator management is considered relatively late for starting ECMO, there are no absolute contraindications for ECMO at this stage, and improvements in oxygenation can be expected. After introducing ECMO, the patient\'s oxygenation capacity improved, and ECMO was successfully withdrawn within 16 days. The patient required long-term rehabilitation but was discharged from the hospital to his home without lingering disease complications on the 150th day of illness and subsequently resumed his former work, daily activities, and quality of life. We conclude that, in regard to the introduction of ECMO for ARDS, it is necessary to reach a comprehensive judgment without being bound by any one index (such as the ventilation management period prior to ECMO introduction).
摘要：
报告的病例是一名68岁的男子，他因患有严重的COVID-19而被我们的三级医疗中心的ICU收治。他在同一医疗中心住院期间,因呼吸病情恶化而入住重症监护病房,其中包括严重急性呼吸窘迫综合征（ARDS）的发展。呼吸机管理始于肺泡保护。在呼吸机管理的第九天，我们认为有必要引入体外膜氧合（ECMO）。尽管呼吸机管理的第九天被认为是开始ECMO的相对较晚，在这个阶段，ECMO没有绝对的禁忌症，和改善氧合是可以预期的。在介绍ECMO之后,患者的氧合能力得到改善，ECMO在16天内成功撤回。病人需要长期康复治疗,但在第150天病倒时已出院回家,并无挥之不去的疾病并发症,随后又恢复以前的工作,日常活动,和生活质量。我们的结论是，关于为ARDS引入ECMO，有必要在不受任何一个指标约束的情况下（例如ECMO引入之前的通风管理时期）达成全面的判断。
