ECMO During COVID-19: A Society of Thoracic Surgeons/Extracorporeal Life Support Organization Survey

Milewski, Rita C.; Chatterjee, Subhasis; Merritt-Genore, HelenMari; Hayanga, J.W. Awori; Grant, Michael C.; Roy, Nathalie; Hirose, Hitoshi; Moosdorf, Rainer; Whitman, Glenn J.R.; Haft, Jonathan W.; Hiebert, Brett; Stead, Christine; Rycus, Peter; Arora, Rakesh C.

doi:10.1016/j.atssr.2022.10.017

Cited by 10 publications

(9 citation statements)

References 10 publications

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“…Extracorporeal membrane oxygenation (ECMO) is important organ support provided to critically ill patients with severe respiratory or circulatory failure. Its use has expanded in the past several years especially, due to the COVID-19 pandemic [ 59 ]. The significant influence of ECMO itself on the PK/PD characteristics of most beta-lactams has been described [ 60 ].…”

Section: Considerations For Patients On Extracorporeal Life Supportmentioning

confidence: 99%

Update on Therapeutic Drug Monitoring of Beta-Lactam Antibiotics in Critically Ill Patients—A Narrative Review

et al. 2023

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Beta-lactam antibiotics remain one of the most preferred groups of antibiotics in critical care due to their excellent safety profiles and their activity against a wide spectrum of pathogens. The cornerstone of appropriate therapy with beta-lactams is to achieve an adequate plasmatic concentration of a given antibiotic, which is derived primarily from the minimum inhibitory concentration (MIC) of the specific pathogen. In a critically ill patient, the plasmatic levels of drugs could be affected by many significant changes in the patient’s physiology, such as hypoalbuminemia, endothelial dysfunction with the leakage of intravascular fluid into interstitial space and acute kidney injury. Predicting antibiotic concentration from models based on non-critically ill populations may be misleading. Therapeutic drug monitoring (TDM) has been shown to be effective in achieving adequate concentrations of many drugs, including beta-lactam antibiotics. Reliable methods, such as high-performance liquid chromatography, provide the accurate testing of a wide range of beta-lactam antibiotics. Long turnaround times remain the main drawback limiting their widespread use, although progress has been made recently in the implementation of different novel methods of antibiotic testing. However, whether the TDM approach can effectively improve clinically relevant patient outcomes must be proved in future clinical trials.

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Section: Considerations For Patients On Extracorporeal Life Supportmentioning

confidence: 99%

Update on Therapeutic Drug Monitoring of Beta-Lactam Antibiotics in Critically Ill Patients—A Narrative Review

et al. 2023

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“…The intravenous heparin drip is the most preferred method secondary to heparin’s short half-life and the ability to closely monitor and adjust dosing. 16 After ECMO cannulas are placed, blood is drained from the vascular system via a mechanical pump. The blood then travels through an oxygenator and heat exchanger.…”

Section: Fundamentals Of Ecmomentioning

confidence: 99%

“… 10 The complication rates for bleeding, emergent surgical intervention, vascular compilations, and intracranial pathology are similar in both the pregnant and non-pregnant population. 20 Although the use of ECMO increased during the COVID pandemic, likely secondary to the number of providers credentialed to perform the procedure 16 , it is important to remember that complications can be severe and the complication rates are high.…”

Section: Pregnancy Outcomes After Ecmomentioning

confidence: 99%

Extracorporeal membrane oxygenation in pregnancy during the SARS-CoV-2 pandemic

Richley¹,

Rao²

2023

Seminars in Fetal and Neonatal Medicine

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“…The operating room staff was reduced to a minimum to save PPE for the personnel in other areas who had direct contact with COVID patients. Operating rooms were recruited as additional intensive care spaces, as they offered the necessary connections for oxygen and compressed air, which were needed for the operation of additional ventilators [ 1 ]. Furthermore, the risks of a perioperative COVID infection had to be weighed against the risks of postponing a non-emergent intervention [ 3 ].…”

Section: First Consequences For Surgical Specialtiesmentioning

confidence: 99%

“…During the initial phase of the COVID-19 pandemic, the core pathology presented as severe pneumonia and rapidly developing lung failure. It became clear very soon that noninvasive measures of respiratory support would not be sufficient for many severely diseased patients and that even invasive ventilation would not suffice in a relevant number of cases [ 1 ]. We all remember the first pictures from Wuhan and not much later from northern Italy, where intensive care units were overwhelmed by a wave of respirator-dependent patients, and very quickly the majority of critical care resources were allocated to COVID patients [ 2 ].…”

mentioning

confidence: 99%

Herzchirurgie während der COVID-19-Pandemie

Moosdorf

2023

Herz

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The COVID-19 pandemic had several specific as well as general implications on cardiac surgery. Acute respiratory distress made extracorporeal oxygenation necessary in a significant number of patients and accordingly many patients were treated in anesthesiological and even more in cardiac surgical intensive care units, which left only a limited number of beds in the intensive care units available for elective surgery cases. Moreover, the necessary availability of intensive care beds for severely diseased COVID-19 patients in general posed a further limit, as did the relevant number of diseased personnel. Specific emergency plans were developed for many heart surgery units, limiting the number of elective cases. Increasing waiting lists were of course stressful for numerous elective-surgery patients and the decreased number of heart operations also meant a financial burden for many units.

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ECMO During COVID-19: A Society of Thoracic Surgeons/Extracorporeal Life Support Organization Survey

Cited by 10 publications

References 10 publications

Update on Therapeutic Drug Monitoring of Beta-Lactam Antibiotics in Critically Ill Patients—A Narrative Review

Update on Therapeutic Drug Monitoring of Beta-Lactam Antibiotics in Critically Ill Patients—A Narrative Review

Extracorporeal membrane oxygenation in pregnancy during the SARS-CoV-2 pandemic

Herzchirurgie während der COVID-19-Pandemie

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