The fall of conventional mechanical ventilation into the emergence of Veno -Venous Extracorporeal Membrane Oxygenation influenced Extreme Super Super obese patient survival with a COVID-19 ARDS


The fall of conventional mechanical ventilation into the emergence of Veno -Venous Extracorporeal Membrane Oxygenation influenced Extreme Super Super obese patient survival with a COVID-19 ARDS


Ali Al Bshabshe1, Omprakash Palanivel2, Mohammed Amer Bahis3, Nasser Mohammed Alwadai3, Naif sulaiman3, Moneer Al Dammad4, Ali Abdullah Kablan4, Hussam Haidar4

1Intensive Care Consultant, Aseer Central Hospital & Professor, Department of Medicine/Critical Care, College of Medicine, King Khalid University, Abha, Aseer Region, Saudi Arabia. 2Cardio- Respiratory Therapy specialist, Department of Respiratory Care Unit, Aseer Central Hospital, Abha, Aseer Region, Saudi Arabia. 3Intensive Care consultant, Department of Intensive Care Unit, Aseer Central Hospital, Abha, Aseer Region, Saudi Arabia.3Cardio- Respiratory Therapy consultants, Department of Respiratory Care Unit, Aseer Central Hospital, Abha, Aseer Region, Saudi Arabia. 4Senior intensive care specialist, Department of Intensive Care Unit, Aseer Central Hospital, Abha, Aseer Region, Saudi Arabia.


The COVID-19 pandemic has unfolded and merged across 220 countries, territories worldwide. Recent studies conclude that obesity is an independent significant risk factor for COVID-19 infection. Thus, obesity is an epidemic disease. Any obesity allied with COVID-19 ARDS is life-threatening, heading to respiratory life support associated with several complications and mortality. In this clinical setting, the World health organization (WHO) and Extracorporeal Life Support Organization (ELSO) provide interim guidelines that Veno-Venous extracorporeal membrane oxygenation (VV- ECMO) can be beneficial in selective COVID-19 patients. However, the benefit of extracorporeal membrane oxygenation (ECMO) in Obesity and Severe Obesity remains controversial. Although a few studies favored ECMO in Obesity associated with COVID-19. In contrast, its benefit in extreme super-super obese (class v) is unknown to the present day. Herein we report our successful early VV- ECMO and its retrieval challenges in an extreme super-super obese of Body mass index (BMI >65 kg/m2). Our report describes our institutional practice, clinical characteristics, and early VV- ECMO induction to enhance patients’ speedy recovery and survival. ECMO is a limited resource and must be used selectively, particularly during a pandemic when all resources are scarce.


Keywords: Coronavirus Disease 19 (COVID-19), Veno-Venous  Extracorporeal  Membrane Oxygenation (VV- ECMO), Blood gas analyses (BGA), Body mass index (BMI), Acute Respiratory Distress Syndrome (ARDS), paO2/FiO2 Ratio (P/F Ratio), Fraction of Inspired Oxygen (FiO2).

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How to cite this article:

Ali Al Bshabshe, Omprakash Palanivel, Mohammed Amer Bahis, . Nasser Mohammed Alwadai, Ali Abdullah Kablan, Moneer Al Dammad, Hussam Haidar. The fall of conventional mechanical ventilation into the emergence of Veno -Venous Extracorporeal Membrane Oxygenation influenced Extreme Super Super obese patient survival with a COVID-19 ARDS . International Journal of Case Reports, 2021; 5:257. DOI: 10.28933/ijcr-2021-11-1905


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