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Coronavirus disease 2019 (COVID-19) can lead to acute respiratory distress syndrome (ARDS), necessitating prolonged mechanical ventilation.1 In some cases, even ventilatory support fails. Venovenous extracorporeal membrane oxygenation (ECMO) has been used in severe cases of respiratory failure.2 However, the need for prolonged ventilation, sedation, and immobility may limit its long-term benefits.3 The application of ECMO in patients with COVID-19 whose condition has rendered mechanical ventilatory support insufficient is not fully established. We present our experience in using single-access, dual-stage venovenous ECMO, with an emphasis on early extubation of patients while they received ECMO support.
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Accepted for Publication: July 23, 2020.
Corresponding Author: Antone J. Tatooles, MD, Cardiothoracic and Vascular Surgical Associates SC, Advocate Christ Medical Center, 4400 W 95th St, Ste 308, Oak Lawn, IL 60453 (firstname.lastname@example.org).
Published Online: August 11, 2020. doi:10.1001/jamasurg.2020.3950
Author Contributions: Drs Mustafa and Tatooles had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Mustafa, Alexander, Joshi, Tabachnick, Cross, Tatooles.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Mustafa, Joshi, Cross, Tatooles.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Mustafa, Joshi.
Administrative, technical, or material support: All authors.
Supervision: Mustafa, Alexander, Tabachnick, Cross, Pappas, Tatooles.
Other—performed substantial part of the procedures: Alexander.
Conflict of Interest Disclosures: Dr Tatooles reported serving as a consultant with Abbott Laboratories outside the submitted work. No other disclosures were reported.
Additional Contributions: We would like to thank Gillian Alex, MD, Rush University Medical Center, for help with institutional board review approvals. She was not compensated for this contribution. We would also like to thank all our brave medical staff, including the intensivists, nurses, physician assistants, nurse practitioners, respiratory therapists, perfusionists, physical therapists, and speech and occupational therapists, among others who selflessly took care of the patients.
Additional Information: All authors performed extracorporeal membrane oxygenation–associated care as attending cardiac surgeons.
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