• Daniel Rinewalt, Anthony Coppolino, Raghu Seethala, Nirmal Sharma, Ali Salim, Steve Keller, and Hari R Mallidi.
• Division of Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
• J Card Surg. 2020 Oct 1; 35 (10): 2869-2871.

BackgroundIn severe cases, the coronavirus disease 2019 (COVID-19) viral pathogen produces hypoxic respiratory failure unable to be adequately supported by mechanical ventilation. The role of extracorporeal membrane oxygenation (ECMO) remains unknown, with the few publications to date lacking detailed patient information or management algorithms all while reporting excessive mortality.MethodsCase report from a prospectively maintained institutional ECMO database for COVID-19.ResultsWe describe veno-venous (VV) ECMO in a COVID-19-positive woman with hypoxic respiratory dysfunction failing mechanical ventilation support while prone and receiving inhaled pulmonary vasodilator therapy. After 9 days of complex management secondary to her hyperdynamic circulation, ECMO support was successfully weaned to supine mechanical ventilation and the patient was ultimately discharged from the hospital.ConclusionsWith proper patient selection and careful attention to hemodynamic management, ECMO remains a reasonable treatment option for patients with COVID-19.© 2020 Wiley Periodicals LLC.

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