Extracorporeal Membrane Oxygenation and Extracorporeal Cardiopulmonary Resuscitation for a COVID-19 Paediatric Patient: A Successful Outcome
Paediatric population have been affected by the Coronavirus disease 2019 (COVID-19) to a much smaller scale compared to the adult population. The severity of the disease is variable ranging from mild form of pneumonia to severe Acute Respiratory Distress Syndrome (ARDS) that necessitates admission to the Intensive Care Unit (ICU) requiring maximal level of organ support. Failure of the maximum support through mechanical ventilation can lead to the consideration of a higher level of organ support through extracorporeal membrane oxygenation (ECMO). We present a case of an 8 years old girl, who presented with severe ARDS secondary to COVID-19 pneumonia for which a venovenous-extracorporeal membrane oxygenation (VV ECMO) was initiated. This was followed by the patient developing cardiac arrest which was managed with extracorporeal cardiopulmonary resuscitation (ECPR). The patient was also given thrombolytic therapy during the ECPR due to high clinical suspicion for pulmonary embolism. VV-A ECMO was then continued and the patient was successfully weaned off both VA and VV ECMO and discharged home with full neurological recovery. This encouraging result will hopefully lead to more consideration of this lifesaving therapy for severe cardiac and respiratory failure secondary to COVID-19 in paediatric patients.