Coronavirus disease 2019 (COVID-19) is characterized by a clinical spectrum of diseases ranging from asymptomatic or mild cases to severe pneumonia with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. Extracorporeal membrane oxygenation (ECMO) has been used as rescue therapy in appropriate patients with COVID-19 complicated by ARDS refractory to mechanical ventilation. In this study, we review the indications, challenges, complications, and clinical outcomes of ECMO utilization in critically ill patients with COVID-19-related ARDS. Most of these patients required venovenous ECMO. Although the risk of mortality and complications is very high among patients with COVID-19 requiring ECMO, it is similar to that of non-COVID-19 patients with ARDS requiring ECMO. ECMO is a resource-intensive therapy, with an inherent risk of complications, which makes its availability limited and its use challenging in the midst of a pandemic. Well-maintained data registries, with timely reporting of outcomes and evidence-based clinical guidelines, are necessary for the careful allocation of resources and for the development of standardized utilization protocols.

2019 冠状病毒病 (COVID-19) 的特点是一系列临床疾病，从无症状或轻症病例到需要机械通气的伴有急性呼吸窘迫综合征(ARDS) 的严重肺炎。体外膜肺氧合 (ECMO) 已被用作适用于机械通气难治性 ARDS 的 COVID-19 患者的抢救治疗。在这项研究中，我们回顾了 ECMO 在患有 COVID-19 相关 ARDS 的危重患者中使用的适应症、挑战、并发症和临床结果。这些患者中的大多数需要静脉-静脉 ECMO。尽管需要 ECMO 的 COVID-19 患者的死亡和并发症风险非常高，但与需要 ECMO 的 ARDS 非 COVID-19 患者相似。ECMO 是一种资源密集型疗法，具有固有的并发症风险，这使得其可用性有限，并且在大流行期间的使用具有挑战性。维护良好的数据登记、及时报告结果和基于证据的临床指南对于仔细分配资源和制定标准化使用方案是必要的。