A single session of HVHF as salvage therapy in the setting of a goal-directed hemodynamic management algorithm may be beneficial in severe refractory hyperdynamic septic-shock patients. This approach may improve hemodynamics and perfusion parameters, acid-base status, and ultimately hospital survival. Moreover, it is feasible, and safe.

At a Glance Commentary Scientific Knowledge on the SubjectExtracorporeal membrane oxygenation (ECMO) has been incorporated in the World Health Organization recommendations for the management of COVID-19-associated severe acute respiratory distress syndrome (ARDS). However, the incidence of ECMO use, its time course and outcomes are unknown at a nationwide level under the COVID-19 pandemic scenario. What This Study Adds to the FieldIn this nationwide study, all patients who received ECMO for severe ARDS during the first wave of COVID-19 pandemic in Chile were identified. The incidence and time course of ECMO use was similar to that observed in the 2009 influenza A(H1N1) pandemic in Australia/New Zealand.The mortality rate was comparable to that reported for other indications of extracorporeal respiratory support. The operation of a National Advisory Commission for Adult ECMO was key to assist patient eligibility, transportation and allocation in tertiary centers in a resource-limited and logistically complex pandemic scenario. These findings might be useful for future COVID-19 pandemic waves worldwide. Total word count: 3475Funding: This investigation had no funding or grant.

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