COVID–19によるARDSを来した短頚の高度肥満女性に対し両側大腿静脈カニュレーションによるECMOを用いて救命した1例(A case of extracorporeal membrane oxygenation with bilateral femoral vein cannulation in a morbidly obese woman with a short neck who had acute respiratory distress syndrome due to coronavirus disease 2019)

Abstract

ABSTRACT We present a case of a morbidly obese 44–year–old woman with a short neck who had nasal discharge 3 days prior to admission. She was diagnosed with acute respiratory distress syndrome due to coronavirus disease 2019 (COVID–19) using severe acute respiratory syndrome–coronavirus–2 polymerase chain reaction test and was admitted to our hospital the following day. Her respiratory condition gradually worsened. On day 9 of hospitalization, she was intubated and transferred to our department. On day 4 after admission to the intensive care unit (ICU), her P/F ratio was 82.6. Therefore, extracorporeal membrane oxygenation (ECMO) was warranted. Since she had a short neck, the cannula could not be inserted through the jugular vein. Therefore, veno–venous ECMO was initiated through the left and right femoral veins. On day 30, the patient was weaned off ECMO. On day 36, she was extubated, and on day 47, she was discharged from the ICU. Finally, on day 55, she was discharged from the hospital. In morbidly obese patients with short necks, VV–ECMO with bilateral femoral venipuncture may be a treatment option. Thus, it is important to understand its advantages and disadvantages to ensure proper management.