EXPERIENCE OF USING ECMO IN CHILDREN WITH SEVERE COVID-19 (DESCRIPTION OF CLINICAL CASES)

Abstract

Summary: Among pediatric patients with COVID-19, about 0,8-1 % require admission to the intensive care unit. The main syndromes that determine the severe course and mortality in children are acute respiratory distress syndrome, multisystem inflammation syndrome and multiple organ failure. In our report, we present two clinical cases of successful use of ECMO in children with COVID-19 who have developed acute respiratory distress syndrome. Description of clinical cases. Children aged 3 years (case 1) and 17 years (case2) were admitted to the intensive care unit with signs of severe respiratory failure. Both patients were diagnosed with SARS-CoV-2 virus infection. Traditional methods of respiratory support in combination with prone position ventilation and myoplegia have not improved oxygenation. With PaO2 / FiO2 – 60 (case 1) and PaO2 / FiO2 – 75 (case 2), children were started V-V ECMO. The duration of ECMO in both patients was 7 days. As a result, improved oxygenation was achieved: PaO2 / FiO2 – 310 (case 1), PaO2 / FiO2 – 264 (case 2) after decannulation, as well as the condition of pulmonary mechanics (Cst increased from 8 to 22 ml / cmH2O in the first case and from 15 ml / cmH2O to 57 ml / cmH2O in the second case, both patients survived and were discharged with minimal cognitive impairment. Conclusion: In cases where critical hypoxemia caused by severe ARDS is not eliminated by traditional methods of respiratory support, ECMO can be an effective rescue technology.