Delivering extracorporeal membrane oxygenation for patients with COVID-19: what, who, when and how?

On 11 March 2020, the World Health Organization (WHO) declared novel coronavirus disease 2019 (COVID-19), caused by severe respiratory syndrome coronavirus-2 (SARS-CoV-2), a worldwide pandemic. Although most patients with SARS-CoV-2 are asymptomatic or experience only mild disease, approximately 14% develop severe disease associated with a high case fatality rate [1-3]. Patients with severe respiratory failure refractory to tracheal intubation, positive pressure ventilation, prone positioning, deep sedation, neuromuscular blockade and other conventional strategies might be considered for venovenous extracorporeal membrane oxygenation (VV-ECMO).