Work

Prolonged ECMO Management (124 Days) in a Severe COVID-19 Patient Complicated by Acute Myocardial Infarction and Thrombocytopenia: A Case Report

Year: 2025

Type: article

Abstract: COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a respiratory illness with high mortality, especially among critically ill patients. The Extracorporeal Life Support Organization (ELSO) COVID-19 Interim Guidelines recommend extracorporeal membrane oxygenation (ECMO) for severe COVID-19 cases when the partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio remains below 80 mmHg despite conventional treatments. We present the case of a 62-year-old male with severe COVID-19 pneumonia who required veno-venous ECMO (V-V ECMO). During his treatment, he experienced an acute myocardial infarction, necessitating percutaneous coronary intervention and stent placement. Although initially a candidate for lung transplantation, complications related to myocardial infarction and heart failure led to delays. Management of anticoagulation and antiplatelet therapy was further complicated by thrombocytopenia secondary to both infection and ECMO therapy. Nevertheless, the patient remained on ECMO for 124 days without oxygenator replacement or significant bleeding events. This case underscores the successful long-term use of V-V ECMO in the face of COVID-19, myocardial infarction, and thrombocytopenia, emphasizing the value of multidisciplinary teamwork and individualized treatment strategies.

Source: Infection and Drug Resistance

DOI: 10.2147/idr.s511482

Authors: Kun Li, Xuejia Pan, Tingting Liu, Dan Zhang, Saiping Jiang, Xueling Fang

Institutions: First Affiliated Hospital Zhejiang University, Zhejiang University

Language: English

Topic: Mechanical Circulatory Support Devices

Subfield: Biomedical Engineering

Field: Engineering

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836