Extracorporeal Oxygenation and COVID-19 Epidemic is the Membrane Fail-Safe to Cross Contamination?

This dissertation seeks to address ECMO clinicians’ concerns regarding the risk of viral dissemination via the oxygenator’s exhaust port. We concluded that it is possible for SARS-CoV-2 to cross the membrane and aerosolize through the gas-exit port of the membrane lung. This phenomenon might be dependent on the presence of viral traces in the bloodstream and on the occurrence of fibers damage, which are both considered rare scenarios. However, it is reasonable to minimize the risk of viral dissemination and cross-contamination: evacuation of the exhaust port of the oxygenator and a strict control for the detection of plasma leakage signs (leading to early oxygenator exchange) are measures that should be taken in order to prevent spreading of aerosols from the membrane lung. Further research is needed to better understand SARS-CoV-2 biodistribution over time during the illness, whereas current data appear to be inconsistent. It would also be relevant to investigate the predisposing factors of the acute-phase reaction leading to membrane lung damage. Resources must be optimized in a pandemic and the dilemma between “doing” and “learning” loudly echoes without an answer. This work highlights that a combined approach is crucial.