In an international collaboration, social media's role in managing a critically ill patient supported veno-venous extracorporeal membrane oxygenation and lessons learned

Objective: To describe a case of a critically ill patient with acute refractory respiratory failure and ARDS managed via a commonly used social media site (WhatsApp) between an International center with ECLS capability and a well-experienced ECLS center-based thousands of miles away in the United States. Methods: A case report. Covid19, a pandemic declared by WHO, ushered in innovation and new technologies, such as video patient conference calls, telemedicine appointments. The impact of social media has also played a considerable role in linking clinicians globally with using platforms such as Zoom or Microsoft Teams to enhance patient care and management. Results: A 41 yr male was admitted to a tertiary hospital in Hyderabad, India, with worsening acute hypoxic respiratory failure, ARDS secondary to influenza pneumonia amidst a devastating pandemic(tested negative for SARS-CoV-2 infection). Tertiary hospital in Hyderabad, being an ECLS capable center but limited by experience in long-term venovenous ECMO management, sought assistance from Allegheny General Hospital, Pittsburgh PA, via a professional media platform LinkedIn. A WhatsApp group was created. The two centers dynamically exchanged 24/7 basis protocols on analgo-sedation, anticoagulation, and veno-venous ECMO weaning, including the critically ill patient's daily care goals. The fruits of 21 days of aggressive VV ECMO support, consideration for an early tracheostomy resulted in a successful trial off ECLS and active pulmonary -physical rehabilitation care placement. The patient returned to the community with an improved physical and mental condition. Conclusions: We describe a unique International collaboration between an ECMO capable center with less experience in managing ECMO and a large ELSO certified center of excellence via a social media platform in the successful outcomes of a critically ill patient ARDS supported by veno venous ECMO. Issues of patient confidentiality and liability, linking of resources are areas of ongoing needed conversation.