The ELSO Guidelines list a BMI ≥ 40 kg/m2 among the relative contraindications to give ECMO treatment in SARS - COV2 patients. We describe a case of a 52-year-old with BMI 50.21 kg/m2, admitted to the intensive care unit (ICU) with severe respiratory conditions and successfully treated with extracorporeal membrane oxygenation (ECMO). The application of veno-venous (VV) ECMO will evolve as far as we understand the pathophysiology of the COVID-19 disease and will probably have a determinant role in management of patient with refractory hypoxemia, whose ventilation management is difficult, even in case of severe obesity.
Keywords: ARDS; COVID-19; Case report; ECMO; Obesity.
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