Successful Management of Critical Acute Respiratory Distress Syndrome following COVID-19 through Extracorporeal Membrane Oxygenation in a Patient with Concurrent Nephrotic Syndrome Relapse

• Published in: Internal Medicine Vol. 62; no. 21; pp. 3209 - 3214
• Main Authors: Muto, Masahiro, Sasaki, Yu, Kano, Toshiki, Fukao, Yusuke, Hosoya, Reina, Nomura, Tomohisa, Sugita, Manabu, Io, Hiroaki, Suzuki, Yusuke
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.11.2023; Japan Science and Technology Agency
• Subjects: Case Report; chronic kidney disease; coronavirus disease 2019; Coronaviruses; COVID-19; extracorporeal membrane oxygenation; Hemodialysis; Hypoxemia; Immunomodulation; Internal medicine; Mechanical ventilation; Nephrotic syndrome; nephrotic syndrome relapse; Oxygenation; Proteinuria; Renal function; Respiratory distress syndrome; nephrotic syndrome relapse; chronic kidney disease; extracorporeal membrane oxygenation; coronavirus disease 2019
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.2293-23

A 44-year-old man with coronavirus disease 2019 (COVID-19) and nephrotic syndrome relapse was admitted to our intensive-care unit for respiratory failure. Despite receiving mechanical ventilation and immunomodulators, the patient experienced refractory hypoxemia, necessitating venovenous extracorporeal membrane oxygenation (VV-ECMO) therapy. Due to a worsening renal function, continuous hemodiafiltration was initiated. After 11 days, his respiratory status gradually improved, and VV-ECMO was withdrawn. The kidney function and proteinuria improved, and hemodialysis was subsequently discontinued. The patient was discharged 64 days after admission. This case highlights the potential benefit of early ECMO application in dramatically promoting recovery in severe COVID-19 cases.