Hipoxemia severa durante ECMO veno-venoso: a propósito de un caso clínico

Extracorporeal membrane oxygenation (ECMO) provides life support in cases of severe acute respiratory failure refractory to conventional management. Despite the improvement in survival in selected patients with severe ARDS, events of severe hypoxemia are not uncommon during support, for which it is necessary to identify the causes and promptly intervene in the patient and in the ECMO circuit. Recirculation, oxygen consumption imbalance, oxygenator failure, and decreased residual lung function are the main causes of severe hypoxemia even during ECMO.

A case of an obese patient with severe ARDS and refractory to SARS CoV-2 in need of ECMO support is described, who during his evolution presented episodes of severe hypoxemia even on ECMO, for which multiple interventions were necessary both in the circuit and in the patient to solve this complication.

This article presents a clinical case, a review of the literature, and a diagnostic and therapeutic algorithm for timely resolution of severe hypoxemia on ECMO.