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OBJECTIVES: In this article, the results of severe coronavirus disease 2019 (COVID‑19) cases followed with extracorporeal membrane oxygenation (ECMO) support in a 3‑month period in the third wave when there were an increased number of cases of young patients in our intensive care unit (ICU) were presented. METHODS: The study was carried out with all COVID‑19 patients who were given ECMO support in our tertiary referral hospital ICU after obtaining the consent of the Ministry of Health Scientific Research Platform and after the approval of the local ethics committee. Patient data were obtained retrospectively from intensive care bedside follow‑up charts and computer records. The demographic and clinical characteristics of the patients were presented in average, median, and percentages. The data of the patients were evaluated and compared with the current literature. RESULTS: ECMO treatment was applied in seven patients who were followed up with severe COVID‑19 pneumonia in the last 3 months. Venovenous extracorporeal membrane oxygenation (VV‑ECMO) was applied to all patients. Five (71.5%) of seven patients were weaned from ECMO. Four (57.2%) of seven patients were discharged from the ICU and hospital in good health. While two of the patients had a cesarean section (C/S) before ECMO, one patient underwent C/S under ECMO. All three newborns were delivered via C/S and all were premature (C/S dates were 35 weeks, 32 weeks, and 27 weeks), and all were discharged from the hospital in good health. CONCLUSION: Our experience shows that ECMO in COVID‑19 patients is a lifesaving treatment option that can be successfully applied in severe acute respiratory distress syndrome cases who do not respond to conventional treatments. [ABSTRACT FROM AUTHOR]

Objective: Drowning is a common and important cause of accidental deaths. Complications and mortality rates are high in patients requiring intensive care unit (ICU) support. The aim of our study was to determine the clinical course and treatment efficacy of a limited number of patients with acute respiratory failure and multiorgan failure due to drowning. Materials and Methods: Patients who were hospitalized >24 hours in the ICU between January 2010 and August 2018 and who met the inclusion criteria were retrospectively analyzed. Results: Of 103 patients admitted to the emergency department over an 8-year period, 13 required intensive care support. Five patients (38.4%) died and eight patients (61.5%) were discharged. Steroids were used in six patients (46.2%), but no statistically significant difference was found in terms of mortality (p=0.592). The presence of diffuse cerebral edema in five patients (38.5%) was associated with a statistically higher mortality rate compared to six patients (46.2%) with normal findings (p=0.003). Mechanical ventilation was performed with synchronized intermittent mandatory ventilation mode in nine patients (69.2%) and with airway pressure-release ventilation (APRV) mode in four patients (31.8%). According to our clinical observations, apparent radiological improvement was detected in patients who received mechanical ventilation with APRV mode. Conclusion: Neither steroids nor prophylactic antibiotherapy are found effective on mortality rates. In addition to these ineffective interventions, mechanical ventilation strategies, the degree of metabolic acidosis at admission and the neurological status of the patient may be considered as variable clinical parameters that may affect patient outcome. [ABSTRACT FROM AUTHOR]

Introduction: Electrical impedance tomography (EIT) is a real-time, non-invasive imaging method that evaluates regional lung ventilation. Although it allows the patient to be monitored at the bedside, it can be a good imaging method especially in pregnant women as it does not contain radiation. Twenty-seven weeks pregnant patient intubated with severe ARDS. The case in which our EIT follow-up played an active role in the decision of radiological progression and delivery. Case: A 28-year-old and 24+4/7 week pregnant woman admitted to our intensive care unit with influenza-A PCR positive ARDS. The patient with bilateral infiltration was started oseltamivir, clarithromycin and methylprednisolone and followed up with high flow oxygen (flow 60 Lt/ min, FiO2 80%).The patient was monitored with EIT because of the concern about computed tomography, which is due to both transport difficulties and pregnancy. An increase in oxygen demand was observed at the 8th hour of hospitalization, and bilateral lung loss was observed in EIT at the same time. The patient, who had confusion and persistent fever, was intubated and emergency cesarean was performed. Linezolid was added after S. aureus was isolated in tracheal aspirate culture. The patient was followed up both daily chest radiograph and EIT. The patient was extubated on the 3rd day of hospitalization and transferred to the service on the 7th day of her hospitalization. Discussion: In the management of pregnant ARDS cases; physicians have to make critical decisions such as birth, termination and intubation. Our patient had severe ARDS and was also 27 weeks pregnant. EIT follow-up was important in the pregnant patient group with limited imaging, since there was no radiation exposure and it gave instant information. This instant information can be used in the pregnant patient population, especially in the follow-up of ARDS patients. These experiences should be supported by multi center studies. [ABSTRACT FROM AUTHOR]