One-Year Outcomes With Venovenous Extracorporeal Membrane Oxygenation Support for Severe COVID-19

Smith, Deane E.; Chang, Stephanie H.; Geraci, Travis C.; James, Les; Kon, Zachary N.; Carillo, Julius; Alimi, Marjan; Williams, David M.; Scheinerman, Joshua A.; Cerfolio, Robert J.; Moazami, Nader; Galloway, Aubrey C.

doi:10.1016/j.athoracsur.2022.01.003

Cited by 22 publications

(13 citation statements)

References 13 publications

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“…Despite an almost normalized FEV and FVC, most patients had an impaired D l CO at 1 year, which was highly correlated with fatigue, thus indicating some residual pulmonary damage. These results concur with findings reported in patients with less severe COVID-19 ( 27 – 29 ) and 27 ECMO survivors after COVID-19–related ARDS ( 30 ). The persistence of fibrotic lesions 6 months after severe ARDS on ECMO is common in patients without COVID-19 and seems to be fixed after 6 months ( 31 – 33 ).…”

Section: Discussionsupporting

confidence: 92%

One-Year Mental and Physical Health Assessment in Survivors after Extracorporeal Membrane Oxygenation for COVID-19–related Acute Respiratory Distress Syndrome

Chommeloux

Valentin

Winiszewski³

et al. 2023

Am J Respir Crit Care Med

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Rationale Long-term outcomes of patients with coronavirus disease (COVID-19)–related acute respiratory distress syndrome treated with extracorporeal membrane oxygenation (ECMO) are unknown. Objectives To assess physical examination, pulmonary function tests, anxiety, depression, post-traumatic stress disorder and quality of life at 6 and 12 months after ECMO onset. Methods Multicenter, prospective study in patients who received ECMO for COVID-19 acute respiratory distress syndrome from March to June 2020 and survived hospital discharge. Measurements and Main Results Of 80 eligible patients, 62 were enrolled in seven French ICUs. ECMO and invasive mechanical ventilation duration were 18 (11–25) and 36 (27–62) days, respectively. All were alive, but only 19/50 (38%) returned to work and 13/42 (31%) had recovered a normal sex drive at 1 year. Pulmonary function tests were almost normal at 6 months, except for D l CO , which was still impaired at 12 months. Mental health, role-emotional, and role-physical were the most impaired domain compared with patients receiving ECMO who did not have COVID-19. One year after ICU admission, 19/43 (44%) patients had significant anxiety, 18/43 (42%) had depression symptoms, and 21/50 (42%) were at risk for post-traumatic stress disorders. Conclusions Despite the partial recovery of the lung function tests at 1 year, the physical and psychological function of this population remains impaired. Based on the comparison with long-term follow-up of patients receiving ECMO who did not have COVID-19, poor mental and physical health may be more related to COVID-19 than to ECMO in itself, although this needs confirmation.

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Section: Discussionsupporting

confidence: 92%

One-Year Mental and Physical Health Assessment in Survivors after Extracorporeal Membrane Oxygenation for COVID-19–related Acute Respiratory Distress Syndrome

Chommeloux

Valentin

Winiszewski³

et al. 2023

Am J Respir Crit Care Med

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“…All patients were discharged home or to acute rehabilitation on room air, except for 1 patient (3.7%), who required supplemental oxygen therapy. At a median follow-up of 10.8 months (interquartile range [IQR], 8.9–14.4 months) since ECMO cannulation, survival was 86.7%, including 1 patient who underwent lung transplantation.” 13 …”

Section: Resultsmentioning

confidence: 99%

“…At a median follow-up of 10.8 months (interquartile range [IQR], 8.9-14.4 months) since ECMO cannulation, survival was 86.7%, including 1 patient who underwent lung transplantation." 13…”

Section: Center Outcomesmentioning

confidence: 99%

Experience of Nurses Caring for COVID-19 Patients Supported by Venovenous Extracorporeal Membrane Oxygenation (ECMO) After ECMO Educational Crash Course

et al. 2022

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During a 6 week period beginning early March 2020, 30 patients with severe coronavirus disease 2019 (COVID-19) were supported with venovenous extracorporeal membrane oxygenation (ECMO). This volume increase mandated rapidly training 116 nurses with no prior ECMO experience via a 2 hour crash course. A qualitative study using semistructured, in-depth interviews was conducted to evaluate the experiences of this unique nursing cohort. Fourteen registered nurses meeting inclusion criteria of no prior ECMO experience, attendance of ECMO educational crash course, direct assignment of COVID-19 patients requiring ECMO, and willingness to consent to recorded interviews participated in the study. Two semistructured interviews were conducted, audio recorded, and transcribed verbatim. Thematic analysis of the interviews was completed using Colaizzi’s phenomenological method. Six themes identified were anxiety and fear of patient harm, isolation and depersonalization, value of didactic education with reinforced clinical experience, professional growth, importance of team collaboration, and pride and gratitude. Subthemes were additionally extracted. Nurses faced multiple obstacles during the pandemic. ECMO added a layer of complexity, as these patients required labor-intensive, high acuity nursing care. The impact of the pandemic and its unique challenges on nursing and medical staff warrants further investigation.

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“…ECMO es una herramienta útil para disminuir la mortalidad y la insuficiencia orgánica en pacientes críticos con hipoxemia refractaria, proporcionando un beneficio con disminución de la mortalidad asociada a distrés respiratorio en paciente críticos con hipoxemia persistente (25,26).…”

Section: Discussionunclassified

Oxigenación con membrana extracorpórea ECMO en hipoxemia refractaria por COVID-19. Un artículo de revisión.

et al. 2022

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La terapia de oxigenación por membrana extracorpórea (ECMO), se utilizó con mucha frecuencia como una medida de soporte vital para tratar la hipoxemia refractaria, principalmente en pacientes con covid-19, desde el año 2020. Este trabajo tiene como objetivos generales evaluar la utilidad del ECMO en la Unidad de cuidados intensivos y como objetivos específicos: determinar la utilidad del ECMO en pacientes con COVID -19 y Conocer la utilidad del ECMO en pacientes que presentan distrés respiratorio severo con hipoxemia refractaria. Se realizo revisión de artículos científicos actuales obtenidos de las bases de datos de alto prestigio y reconocimiento internacional tales como Pubmed, New England Journal of Medicine, guías internacionales, Journal of critical care, guías de la OMS, entre otras. Artículos en su mayoría del año 2019 en adelante, en los idiomas español e inglés. Se seleccionaron 26 artículos. Artículos de revisión, meta-análisis, estudios observacionales, descriptivos, retrospectivos y opiniones de autores sobre el tema Oxigenación con membrana extracorpórea (ECMO) en hipoxemia refractaria por COVID-19 y se obtuvo como resultado que el ECMO, es una herramienta útil para disminuir la mortalidad y la insuficiencia orgánica en pacientes críticos con hipoxemia refractaria, proporcionando un beneficio con disminución de la morbimortalidad asociada a distrés respiratorio en pacientes críticos con hipoxemia persistente. Se concluye que es un tratamiento eficaz ocasionados por infección por COVID-19.

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One-Year Outcomes With Venovenous Extracorporeal Membrane Oxygenation Support for Severe COVID-19

Cited by 22 publications

References 13 publications

One-Year Mental and Physical Health Assessment in Survivors after Extracorporeal Membrane Oxygenation for COVID-19–related Acute Respiratory Distress Syndrome

One-Year Mental and Physical Health Assessment in Survivors after Extracorporeal Membrane Oxygenation for COVID-19–related Acute Respiratory Distress Syndrome

Experience of Nurses Caring for COVID-19 Patients Supported by Venovenous Extracorporeal Membrane Oxygenation (ECMO) After ECMO Educational Crash Course

Oxigenación con membrana extracorpórea ECMO en hipoxemia refractaria por COVID-19. Un artículo de revisión.

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