Voenno-medicinskij žurnalVoenno-medicinskij žurnal0026-9050Eco-Vector8254010.17816/RMMJ82540Research ArticleA case of long - term extracorporeal membrane oxygenation in the treatment of acute respiratory distress syndrome in a patient with COVID-19KryukovE. Vevgeniy.md@mail.ruChernetsovV. A-ShestopalovA. E-StetsV. V-ZhuravlevA. G-MorgachevV. V-MeshcheryakovD. S-The N.N.Burdenko Main Military Clinical Hospital of the Ministry of Defense of the Russian Federation150120213421767906102021Copyright © 2021, Eco-Vector2021The most common clinical manifestation of COVID-19 is a bilateral lung disease, with acute respiratory distress syndrome (ARDS) developing in 3-4% of cases. The experience of using extracorporeal membrane oxygenation with the ineffectiveness of mechanical ventilation in the treatment of ARDS in patients with coronavirus infection is insignificant. The article demonstrates a case of long - term (30 days) use of extracorporeal membrane oxygenation in a patient with viral total lung disease, CT-4, severe acute respiratory distress syndrome. The possibility and efficiency of the long - term application of the method are presented. Anticoagulant therapy using low molecular weight heparin (enoxaparin) is adequate, reduces the risk of bleeding, determines the duration and effectiveness of using a membrane oxygenator, and reduces the likelihood of thrombosis of the extracorporeal circuit, and preserves its oxygenating function.COVID-19extracorporeal membrane oxygenationacute respiratory distress syndromeCOVID-19viral total lung diseasecoagulopathyэкстракорпоральная мембранная оксигенацияострый респираторный дистресс-синдромвирусное тотальное поражение легкихкоагулопатия[Abrams D., Ferguson N., Brochard L. et al. ECMO for ARDS: from salvage to standard of care? // The Lancet Respiratory Medicine. - 2019. - Vol. 7, N 2. - P. 108-110.][Extracorporeal Life Support Organization, General Guidelines for all ECLS Cases, 2019.][https://sccm.org/SurvivingSepsisCampaign /Guidelines/COVID-19][https://www.eurolso.net/ Guidelines for ECMO in COVID-19][https://www.elso.org/Resources/Guide lines.aspx][Li M., Gu S-Ch., Wu X-C. et al. Extracorporeal membrane oxygenation support in 2019 novel coronavirus disease: indications, timing, and implementation // Chinese Med. J. - 2020. - Vol. 133, N 9. - P. 1115-1117.][Ramanathan K., Antognini D., Combes A. et al. Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases // Lancet Respir Med. - 2020. - Vol. 8, Iss. 5. - P. 518-526.]