Extracorporeal membrane oxygenation (ECMO) use has been increasing in severe respiratory and/or cardiac failure despite implementation of conventional care. This technology has been proven valuable in treating viral pneumonia during the pandemic influenza A H1N1 in 2009.

The epidemics caused by the Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012 led to a fatality rate of up to 34.4%.

The therapeutic effect of ECMO should be considered in MERS, whose causes of death during the epidemics were predominantly refractory hypoxemia and multi-organ failure, similar to COVID-19.

Alshahrani MS et al reported 35 MERS-CoV infected patients who were critically ill with refractory hypoxemia (partial pressure of arterial oxygen [PaO2]/fraction of inspired oxygen [FiO2] <100 mm Hg), of which 17 had received venous-venous ECMO (VVECMO). Compared with that in patients receiving only conventional respiratory care, the fatality of those who had received ECMO was significantly lower (100% vs. 65%). Because the evidence for recovering from COVID-19 with ECMO is extremely limited so far, we can learn from the previous experiences in the treatment of similar severe viral pneumonia cases through retrospective literature review and data analysis.

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