Early Initiation of Veno-venous Extracorporeal Membrane Oxygenation in the Emergency Room as A Salvage Treatment for Patients with Coronavirus Disease 2019 with Severe Acute Respiratory Distress Syndrome

Background: Since veno-venous extracorporeal membrane oxygenation (VV-ECMO) is highly invasive and may be used over a long period of time, its introduction is usually carefully considered and planned. Here, we report the case of a life-saving procedure by introducing VV-ECMO in the emergency room. Case presentation: A 56 year-old man had fatigue for 3 days along with rapidly worsening dyspnea. On arrival at the emergency room, he presented with severe hypoxemia. Tracheal intubation and mechanical ventilation were immediately initiated; however, hypoxemia persisted. Therefore, VV-ECMO was introduced in the emergency room. The patient's respiratory condition gradually improved, and VV-ECMO was terminated on hospital day 6. Conclusion: The early introduction of VV-ECMO in the emergency room was effective against acute respiratory distress syndrome caused by coronavirus disease 2019. Further studies should be performed to confirm the efficacy of early VV-ECMO introduction.