SUBLINGUAL MICROCIRCULATION IN PATIENTS WITH SARS-CoV-2 UNDERGOING VENO-VENOUS EXTRACORPOREAL MEMBRANE OXYGENATION

Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) is a rescue treatment for severe acute respiratory failure refractory to conventional ventilation. We examined the alterations of sublingual microcirculation in patients with SARS-CoV-2 during VV-ECMO treatment and assessed the relationship between microvascular parameters and ventilation, hemodynamics, and laboratory tests. Nine patients were included in the study and the following microcirculatory parameters were estimated: TVD 16.81 (14.46-18.6) mm/mm2; PVD 15.3 (14.09-17.96) mm/mm2; PPV 94.85% (93.82%-97.79%); MFI 2.5 (2.5-2.92); HI 0.4 (0.18-0.4). TVD and PVD were inversely related to D-dimer levels (rho=-0.667, p=0.05 and rho=-0.733, p=0.025 respectively), aspartate aminotransferase (AST) (rho=-0.886, p=0.019 and rho=-0.886, p=0.019 respectively) and alanine aminotransferase (ALT) (rho=-0.829, p=0.042 and rho=-0.829, p=0.042 respectively). Our results showed an altered sublingual microcirculation in patients receiving VV-ECMO for severe SARS-CoV-2 and suggest a potential contribution of endothelia dysfunction to determine microvascular alteration.