Back to Search
Start Over
Veno-venous Extracorporeal Membrane Oxygenation for Respiratory Failure in COVID-19 Patients
- Source :
- Annals of Surgery
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Summary and Background Data: VV ECMO can be utilized as an advanced therapy in select patients with COVID-19 respiratory failure refractory to traditional critical care management and optimal mechanical ventilation. Anticipating a need for such therapies during the pandemic, our center created a targeted protocol for ECMO therapy in COVID-19 patients that allows us to provide this life-saving therapy to our sickest patients without overburdening already stretched resources or excessively exposing healthcare staff to infection risk. Methods: As a major regional referral program, we used the framework of our well-established ECMO service-line to outline specific team structures, modified patient eligibility criteria, cannulation strategies, and management protocols for the COVID-19 ECMO program. Results: During the first month of the COVID-19 outbreak in Massachusetts, 6 patients were placed on VV ECMO for refractory hypoxemic respiratory failure. The median (interquartile range) age was 47 years (43–53) with most patients being male (83%) and obese (67%). All cannulations were performed at the bedside in the intensive care unit in patients who had undergone a trial of rescue therapies for acute respiratory distress syndrome including lung protective ventilation, paralysis, prone positioning, and inhaled nitric oxide. At the time of this report, 83% (5/6) of the patients are still alive with 1 death on ECMO, attributed to hemorrhagic stroke. 67% of patients (4/6) have been successfully decannulated, including 2 that have been successfully extubated and one who was discharged from the hospital. The median duration of VV ECMO therapy for patients who have been decannulated is 12 days (4–18 days). Conclusions: This is 1 the first case series describing VV ECMO outcomes in COVID-19 patients. Our initial data suggest that VV ECMO can be successfully utilized in appropriately selected COVID-19 patients with advanced respiratory failure.
- Subjects :
- Adult
Male
VV-ECMO
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Pneumonia, Viral
law.invention
Betacoronavirus
03 medical and health sciences
0302 clinical medicine
Interquartile range
law
Extracorporeal membrane oxygenation
Humans
Medicine
Pandemics
Stroke
Mechanical ventilation
Academic Medical Centers
Respiratory Distress Syndrome
SARS-CoV-2
business.industry
COVID-19
Middle Aged
extracorporeal membrane oxygenation
medicine.disease
Intensive care unit
Prone position
Pneumonia
surgical procedures, operative
Massachusetts
Respiratory failure
030220 oncology & carcinogenesis
Emergency medicine
Female
ARDS
030211 gastroenterology & hepatology
Surgery
Covid Papers
Coronavirus Infections
business
Subjects
Details
- ISSN :
- 15281140 and 00034932
- Volume :
- 272
- Database :
- OpenAIRE
- Journal :
- Annals of Surgery
- Accession number :
- edsair.doi.dedup.....7d21c60ee79e4443ac934d6e5e515dad