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The vascular cannulation step is of great importance for the effective and safe implementation of extracorporeal membrane oxygenation (ECMO) support. We experienced various problems associated with ECMO vascular cannulation (malposition, thrombosis, recannulation, collapse) in 3 patients who developed coronavirus disease-2019 acute respiratory distress syndrome and received veno-venous ECMO support, and here we share our experience in their management. Appropriate vascular cannula size, vascular cannula structure, selection of the vascular cannulation site, and precise vascular cannulation can make ECMO support more effective and reliable. [ABSTRACT FROM AUTHOR]

Hypercoagulopathy associated with the novel coronavirus disease (COVID-19) is the leading cause of acute respiratory distress syndrome (ARDS), multiple organ failure, and mortality. Extracorporeal membrane oxygenation (ECMO) has been used to manage patients with COVID 19-associated severe respiratory or cardiac failure. In this report, we aim to summarise our experience with deadly thrombotic complications during venovenous ECMO (vvECMO) treatment in 6 patients with COVID-19-associated ARDS between March 19, 2020 and April 20, 2020. Based on our experience with 6 COVID-19-associated ARDS patients on ECMO, we intend to raise awareness regarding thrombotic complications leading to mortality. [ABSTRACT FROM AUTHOR]

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Extracorporeal membrane oxygenation (ECMO) may be the last option in patients with severe acute respiratory distress syndrome (ARDS) in whom conventional methods have failed. The best results are obtained in patients with severe ARDS after trauma. Injured lungs can recover completely with ECMO therapy. A 44-year-old male patient was brought to the emergency department after sustaining severe thoracic gunshot injury. The patient was rushed into emergency surgery; however, pneumonectomy could not be performed due to morphological variation and widespread contusion in the lungs. The patient had flail chest with extensive damage of the ribs. Titanium plates could not be placed, as there was a major loss in the bone tissue. After cutting the fractured rib ends, the open chest wall was repaired with dual mesh and covered with serratus and latissimus dorsi muscles. However, the flail chest could not be corrected. During the follow-up in the intensive care unit, the patient developed ARDS and conventional therapies were unsuccessful. Thus, ECMO was used to allow lung healing. ECMO treatment was continued for seven days and was completed without any complications. The patient was transferred to the regular ward after 29 days. ECMO can be used as a life-saving treatment that allows lung healing in case conventional treatment methods have failed. [ABSTRACT FROM AUTHOR]

Introduction: Experiences in the COVID-19 pandemic have also shown us that extracorporeal membrane oxygenation (ECMO) is very effective in facilitating the response to treatment in severe acute respiratory distress syndrome (ARDS) patients who do not respond to conventional methods. Materials and Methods: The case we are going to present was 46 years old, influensa positive female with known diabetes mellitus, who was intubated with severe ARDS, which developed as a result of pneumonia caused by viral, bacterial and fungal pathogens. Despite positive pressure ventilation, prone position, neuromuscular blockade to eliminate ventilator asynchrony and appropriate medical treatment, the patient’s hypoxemia could not be corrected. In arterial blood gas evaluation, pO2 : 68.5 mmHg, pCO2 : 28.5 mmHg, SpO2 : 97.7%, pO2 /FiO2 ratio was 97. She has severe ARDS (Figure 1). Results: Venovenous ECMO was started to the patient for the treatment of severe ARDS. the arterial blood gas taken at this time, pO2 : 147 mmHg, pCO2 : 30 mmHg, pO2 /FiO2 >300, was observed. On the 8th day of the procedure, ECMO was successfully decannulated. No complications were encountered during the ECMO procedure. On the 33rd day of hospitalization, the patient was discharged home without the need for oxygen support. Conclusion: With this case, we have seen once again that ECMO, with a professional multidisciplinaryapproach and start in correct time, is of great importance in improving the prognosis in youngpatients with severe ARDS without serious co-morbidities. [ABSTRACT FROM AUTHOR]

Introduction: The need for mechanical ventilation and mortality rates are high as a result of acute respiratory distress syndrome (ARDS) developing after COVID-19. The role of Extracorporeal Membrane Oxygenation (ECMO) supportive therapy in the COVID-19 pandemic is still unclear. In our study, we aimed to share the effectiveness of the ECMO supportive treatment, the difficulties we encountered, and our clinical experiences in 26 patients with ARDS caused by COVID-19 pneumonia in the intensive care unit of a third-level training and research hospital during the pandemic period. Materials and Methods: Patients who received ECMO support between 11.03.2020 and 01.03.2021 in the University of Health Sciences Turkey, Prof. Dr. Cemil Taşcıoğlu City Hospital were evaluated retrospectively. During the study period, ECMO supportive treatment was applied to 26 patients due to ARDS. Results: A total of 26 patients underwent V-V ECMO and 2 patients could be decannulated. Sixteen (61.5%) of the patients were male, 10 (38.5%) were female, with a mean age of 51.3 (29-71). Mean time from hospitalization to intubation was 10.1±5.9 (1-27) days, mean duration of stay on mechanical ventilator before ECMO was 9.7±7.2 (1-28) days, mean duration of stay on ECMO support was 12. It was found to be 3 (1-23) days (Table 1). Of the 26 patients who received ECMO support, 24 died. One of the surviving patients left ECMO support after 13 days and the other 16 days later. After ECMO, MV support continued for 21 days and 16 days, respectively. Surviving patients were discharged with full recovery. ECMO was terminated due to bleeding in two patients and cannula removal in two patients. Conclusion: ECMO supportive therapy is associated with high mortality in ARDS patients developing after COVID-19. However, in COVID 19 disease, ECMO is a life-saving support method when applied in the early period. The usefulness of ECMO as a rescue therapy in critically ill patients with ARDS due to COVID-19 has so far been limited and more studies are needed for its application in these patients. [ABSTRACT FROM AUTHOR]

Objective: The new coronavirus disease, in which hundreds of thousands of people are infected in the world, appears in tables ranging from asymptomatic course to severe acute respiratory distress syndrome. Extracorporeal membrane oxygenation (ECMO) is one of the salvage treatments applied in intubated patients due to high mortality. We aimed to describe our experience in a COVID-19 infected pregnant woman with ECMO theraphy in our clinic. Case: A 37-year-old patient who was 34 weeks pregnant presented with a fever of 39 °C for 3 days, and a cough. Because of the appearance of bilateral ground glass on CT, viral pneumonia. She was admitted into our intensive care unit, and high dose of vitamin C, and tocilizumab (a humanized monoclonal antibody against the interleukin-6 receptor) were added to the treatment. The patient had increased respiratory difficulty (SpO2: %83) and was taken under the support of MV. Venovenous ECMO treatment was planned on the third day of intubation The results of a laboratory examination were leukocyte: 14.03 K/uL; neutrophiltolymphocyte ratio: 19.35; C-reactive protein: 244.8 mg/L; ferritin: 140.7 µg/L; procalcitonin: 14.7 ng/mL; D-dimer: 13.300 ng/mL and fibrinogen: 790 mg/Dl. The first polymerase chain reaction test was evaluated as SARSCoV-2 positive favipiravir 200 mg PO 2x3, piperacilin-tazobactam 3x4,5 gr IV and enoxaparin 6000 IU SC 2x1 were initiated. On the seventh day of ECMO, the patient developed sudden hypotension, metabolic acidosis, and P/F rate quickly dropped below 100. The patient died despite all the necessary interventions. Conclusion: ECMO indications are respiratory insufficiency, P/F ratio below 100, MV time of less than 7 days, age below 65 years. We could not achieve a successful result, we believe that new experiences. [ABSTRACT FROM AUTHOR]

Lung injury resulting from inhalation of chemical products continues to be associated with high morbidity and mortality. Concentrated nitric acids are also extremely corrosive fuming chemical liquids. Fumes of nitric acid (HNO3) and various oxides of nitrogen such as nitric oxide (NO) and nitrogen dioxide (NO2) may cause fatal illnesses such as severe pulmonary edema and acute respiratory distress syndrome (ARDS) when inhaled. Intensive respiratory management including mechanical ventilation with positive end expiratory pressure (PEEP), inverse ratio ventilation, replacement of surfactant and extracorporeal membrane oxygenation (ECMO), steroids and n-acetylcysteine (NAC) may improve survival. In this case report we present the diagnosis and successful treatment of a 57 years old male patient who developed ARDS following pulmonary edema due to nitric acid fumes inhalation. [ABSTRACT FROM AUTHOR]