Extracorporeal Membrane Oxygenation for Patients With COVID-19 in Severe Respiratory Failure

Mustafa, Asif K.; Alexander, Philip; Joshi, Devang J.; Tabachnick, Deborah; Cross, Chadrick A; Pappas, Patroklos; Tatooles, Antone

doi:10.1001/jamasurg.2020.3950

Cited by 171 publications

(235 citation statements)

References 6 publications

Supporting

Mentioning

225

Contrasting

Unclassified

Order By: Relevance

“…In our small cohort of SARS-COV-2 ECMO patients, we have observed a survival rate of 78% despite initial reports suggesting a lack of efficacy. This is similar to results from two further published cohorts from Paris and North America [3,4].…”

Section: Discussionsupporting

confidence: 91%

“…Extracorporeal membrane oxygenation (ECMO) is an extracorporeal technique providing respiratory and cardiac support in selected patients with severe cardiac or respiratory failure. Initial reports on the use of ECMO in COVID-19 reported a very high mortality [2]; however, a growing body of evidence has challenged these initial findings [3,4]. In this article, we describe our experience with this technology in COVID-19 patients.…”

Section: Introductionmentioning

confidence: 94%

See 1 more Smart Citation

SARS-CoV-2 and ECMO: early results and experience

Akhtar

Olusanya

Baladía

et al. 2020

Indian J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Introduction In this paper, we describe our experience and early outcomes with critically unwell severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients who required extracorporeal membrane oxygenation (ECMO). We present our standard practices around ECMO decision-making, retrieval, cannulation, ventilation, anticoagulation, tracheostomy, imaging and steroids. Methods A retrospective cohort study using data from the hospital notes on all SARS-CoV-2 patients who required extracorporeal support at St Bartholomew's Hospital between 1 March 2020 and 31 July 2020. In total, this included 18 patients over this time period. Results In total, 18 patients were managed with extracorporeal support and of these 14 survived (78%) with 4 deaths (22%). The mean duration from hospital admission to intubation was 4.1 ± 3.4 days, mean time from intubation to ECMO 2.3 ± 2 days and mean run on ECMO 17.7 ± 9.4 days. Survivor mean days from intubation to extubation was 20.6 ± 9.9 days and survivor mean days from intubation to tracheostomy decannulation 46.6 ± 15.3 days. Time from hospital admission to discharge in survivors was a mean of 57.2 ± 25.8 days. Of the patients requiring extracorporeal support, the initial mode was veno-venous (VV) in 15 (83%), veno-arterial (VA) in 2 (11%) and veno-venous-arterial (VVA) in 1 (6%). On VV extracorporeal support, 2 (11%) required additional VVA. Renal replacement therapy was required in 10 (56%) of the patients. Anticoagulation target anti-Xa of 0.2-0.4 was set, with 10 (56%) patients having a deep vein thrombosis or pulmonary embolism detected and 2 (11%) patients suffering an intracranial haemorrhage. Tracheostomy was performed in 9 (50%) of the patients and high-dose methylprednisolone was given to 7 (39%) of the patients. Conclusion In our cohort of patients with severe SARS-CoV-2 respiratory failure, a long period of invasive ventilation and extracorporeal support was required but achieving good outcomes despite this. There was a significant burden of thromboembolic disease and renal injury. A significant proportion of patients required tracheostomy and steroids to facilitate weaning.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 94%

SARS-CoV-2 and ECMO: early results and experience

Akhtar

Olusanya

Baladía

et al. 2020

Indian J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

show abstract

“…Finally, medical devices, such as ventilators, are important for the treatment of infected patients, to provide oxygen and ensure airflow in the lungs. Alternatively, extracorporeal membrane oxygenation (ECMO) can be applied in patients with severe respiratory failure to promote their recovery process 94 . In this procedure, venous blood is drained from the body, oxygenated using a gas-exchange device and then returned to the body 95 ( fig.…”

Section: Treatment and Vaccinationmentioning

confidence: 99%

A materials-science perspective on tackling COVID-19

et al. 2020

View full text Add to dashboard Cite

show abstract

“…While early evidence shows that there is some benefit to patients infected with COVID-19 who receive early ECMO support for persistent ARDS or pneumonia, many unknowns still exist. 1,2 Air rotary wing critical care transport programs evolved and pivoted to ensure safety for both patients and crews while providing high quality critical care for patients. Through "ECMO-on-the-Go," collaboration between Hartford HealthCare's Heart and Vascular Institute and LIFE STAR, our air medical program, we are able to provide primary ECMO capabilities, when patients deemed too unstable for interfacility transfer can have ECMO implanted at the sending center for stabilization with subsequent transfer to a tertiary care center, to COVID-19 patients with severe respiratory failure.…”

Section: Introductionmentioning

confidence: 99%

Air Medical Transport of Patients Diagnosed With Confirmed Coronavirus Disease 2019 Infection Undergoing Extracorporeal Membrane Oxygenation: A Case Review and Lessons Learned

Bascetta

Bolton

Kurtzman

et al. 2021

Air Medical Journal

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

Extracorporeal Membrane Oxygenation for Patients With COVID-19 in Severe Respiratory Failure

Abstract: who assisted with the development of the analytic plan and concept development. Dr Ellis was not compensated.

Cited by 171 publications

References 6 publications

SARS-CoV-2 and ECMO: early results and experience

SARS-CoV-2 and ECMO: early results and experience

A materials-science perspective on tackling COVID-19

Air Medical Transport of Patients Diagnosed With Confirmed Coronavirus Disease 2019 Infection Undergoing Extracorporeal Membrane Oxygenation: A Case Review and Lessons Learned

Contact Info

Product

Resources

About