Extracorporeal membrane oxygenation as a possible terapeutical measure to pacients affected by COVID-19
INTRODUCTION: The SARS-CoV-2 is a virus that infects mainly the respiratory tract commonly causing an acute respiratory infection. According the World’s Health Organization, about 80% of the population will be asymptomatic and 20% of cases would need intensive care and ventilatory support. The infecction by SARS-CoV-2 is based on the interaction between a protein called the Spike and a domain of the Angiotensin Converting Enzime 2 (ACE-2), using the S1 portion of the viral protein. The ACE-2 is present on cells like enterocytes, type 2 pneumocytes and vascular endothelial cells, the main function of which is to cleave angiotensin into angiotensin- (1-7). OBJECTIVE: Describe the extracorporeal membrane oxygenation system as na alternative terapy to severe ptients of Covid-19. METHODOLOGY: It was used a qualitative and explanatory approach, having as data banks the research on domains like National Center for Biotechnology Information (NCBI) and Scientific Electronic Library Online (SciELO), where were searched related articles, whom report about ECMO and Covid-19. On other hand, it has a vasodilating effect, reducing blood pressure and antagonizing angiotensin 2. RESULTS: Extracorporeal membrane oxygenation could be configurated on venomous (ECMO-VV), chosen when occours a respiratory failure with a preserved cardiac function, and venoarterial (ECMO- VA), when there is indication of cardiac support with preserved lung function or not. When infected by SARS-CoV-2, the human alveolar epithelial cells are affected, appearing the symptons, many times associated to a acute respiratory syndrom, having on the extracorporeal membrane oxygenation the possibility of temporary support to the failure of lung or heart function, refractory to convencional clinic treatment, becaue this tecnique provides oxygen and carbon dioxide (CO2) directly from blood, when there is a commitment of organs that make impossible the gas exchange. CONCLUSION: Although it still difficult to access due to certain factors, such as the cost of equipment and the training of professionals in the field, extracorporeal membrane oxygenation favors the care of patients affected by severe pulmonary diseases, which can increase survival and better recovery in cases of Covid-19 or similar infections.
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