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Clinical GuidelinesClinical Practice Guidelines
Open Access

The Saudi Critical Care Society extracorporeal life support chapter guidance on utilization of veno-venous extracorporeal membrane oxygenation in adults with acute respiratory distress syndrome and special considerations in the era of coronavirus disease 2019

Hani N. Mufti, Ahmed A. Rabie, Alyaa M. Elhazmi, Husam A. Bahaudden, Mostafa A. Rajab, Ismael S. Al Enezi, Ayed Y. Assiri, Khalid A. Maghrabi, Ali A. Al Bshabshe, Abdullah M. Abudayah, Adel A. Tash, Awad A. Al-Omari and Mohamed H. Azzam
Saudi Medical Journal June 2021, 42 (6) 589-611; DOI: https://doi.org/10.15537/smj.2021.42.6.20200520
Hani N. Mufti
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Ahmed A. Rabie
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Alyaa M. Elhazmi
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Husam A. Bahaudden
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Mostafa A. Rajab
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Ismael S. Al Enezi
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Ayed Y. Assiri
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Khalid A. Maghrabi
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Ali A. Al Bshabshe
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Abdullah M. Abudayah
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Adel A. Tash
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Awad A. Al-Omari
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Mohamed H. Azzam
From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
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Article Information

vol. 42 no. 6 589-611
DOI 
https://doi.org/10.15537/smj.2021.42.6.20200520
PubMed 
34078721

Published By 
Saudi Medical Journal
Online ISSN 
1658-3175
History 
  • Received February 26, 2021
  • Accepted April 9, 2021
  • Published online June 2, 2021.

Copyright & Usage 
Copyright: © Saudi Medical Journal This is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work.

Author Information

  1. Hani N. Mufti, MD, FRCSC⇑,
  2. Ahmed A. Rabie, MD,
  3. Alyaa M. Elhazmi, MD,
  4. Husam A. Bahaudden, MD, FRCPC,
  5. Mostafa A. Rajab, MD,
  6. Ismael S. Al Enezi, CCP,
  7. Ayed Y. Assiri, MD,
  8. Khalid A. Maghrabi, MD, FACP,
  9. Ali A. Al Bshabshe, MD, FRCP,
  10. Abdullah M. Abudayah, MD, SFCCM,
  11. Adel A. Tash, MD,
  12. Awad A. Al-Omari, MD and
  13. Mohamed H. Azzam, MD, FRCPC
  1. From the Department of Cardiac Sciences (Mufti), from the Department of Intensive Care (Bahaudden), King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; from the College of Medicine (Mufti, Bahaudden), King Saud bin Abdulaziz University for Health Sciences; from Department of Medical Research (Mufti, Bahaudden), King Abdullah International Medical Research Center; from the Department of Cardiac Sciences (Tash) and from the Department of Intensive Care (Azzam), King Abdullah Medical Complex, Ministry of Health, Jeddah; from the College of Medicine (Bshabshe), King Khalid University, Abha; from the Critical Care Department (Rabie), King Saud Medical City; from the Department of Critical Care (Elhazmi, Al-Omari), from the Research Center (Elhazmi, Al-Omari), Dr. Sulaiman Al Habib Medical Group; from the Critical Care Department (Rajab, Enezi, Assiri), Prince Mohammad bin Abdulaziz Hospital; from the Intensive Care Department (Maghrabi), King Faisal Specialist Hospital and Research Center; from the Department of Intensive Care Services (Abudayah), Prince Sultan Military Medical City; and from the School of Medicine (Al-Omari), Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
  1. Address correspondence and reprint request to: Dr. Hani Mufti, Division of Cardiac Surgery, Department of Cardiac Sciences, King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia. E-mail: muftihn{at}ngha.med.sa ORCID ID: https://orcid.org/0000-0002-0471-5738
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Saudi Medical Journal: 42 (6)
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Vol. 42, Issue 6
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The Saudi Critical Care Society extracorporeal life support chapter guidance on utilization of veno-venous extracorporeal membrane oxygenation in adults with acute respiratory distress syndrome and special considerations in the era of coronavirus disease 2019
Hani N. Mufti, Ahmed A. Rabie, Alyaa M. Elhazmi, Husam A. Bahaudden, Mostafa A. Rajab, Ismael S. Al Enezi, Ayed Y. Assiri, Khalid A. Maghrabi, Ali A. Al Bshabshe, Abdullah M. Abudayah, Adel A. Tash, Awad A. Al-Omari, Mohamed H. Azzam
Saudi Medical Journal Jun 2021, 42 (6) 589-611; DOI: 10.15537/smj.2021.42.6.20200520

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The Saudi Critical Care Society extracorporeal life support chapter guidance on utilization of veno-venous extracorporeal membrane oxygenation in adults with acute respiratory distress syndrome and special considerations in the era of coronavirus disease 2019
Hani N. Mufti, Ahmed A. Rabie, Alyaa M. Elhazmi, Husam A. Bahaudden, Mostafa A. Rajab, Ismael S. Al Enezi, Ayed Y. Assiri, Khalid A. Maghrabi, Ali A. Al Bshabshe, Abdullah M. Abudayah, Adel A. Tash, Awad A. Al-Omari, Mohamed H. Azzam
Saudi Medical Journal Jun 2021, 42 (6) 589-611; DOI: 10.15537/smj.2021.42.6.20200520
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  • Article
    • Abstract
    • I. Introduction
    • II. Patient selection criteria
    • III. Important considerations for ECMO cannulation
    • IV. ECMO management
    • V. Troubleshooting
    • VI. Eextracorporeal membrane oxygenation during the COVID-19 pandemic and special considerations
    • Acknowledgment
    • Appendix A
    • Footnotes
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Keywords

  • adult
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© 2025 Saudi Medical Journal Saudi Medical Journal is copyright under the Berne Convention and the International Copyright Convention.  Saudi Medical Journal is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work. Electronic ISSN 1658-3175. Print ISSN 0379-5284.

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