Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome: How do we Expand Capacity in the COVID-19 Era?
Despite advances in medical technology, the mortality rate for severe acute respiratory distress syndrome (ARDS) remains high at around 40%. In recent years, multiple studies, systematic reviews, and meta-analyses, including the study in this issue of Heart, Lung and Circulation published by Wang and colleagues, have indicated that treatment with veno-venous extracorporeal membrane oxygenation (VV-ECMO) may be associated with better outcomes in severe ARDS than conventional mechanical ventilation.
Prone Positioning during Venovenous Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome. A Multicenter Cohort Study and Propensity-matched Analysis
The aim of the study was to assess the feasibility, safety, and effect on oxygenation and lung mechanics of PP during ECMO. As a secondary exploratory aim, we assessed the association between PP and hospital mortality.
Impact of CytoSorb on Kinetics of Vancomycin and Bivalirudin in Critically ill Patients
CytoSorb is effective in mitigating the systemic inflammatory response and safe with respect to vancomycin and bivalirudin administration. These preliminary data further support the use of CytoSorb as adjunct therapy in critically ill patients.
Outcome Prediction in Patients with Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation-A Retrospective International Multicenter Study
In this study, we assess survival in an international multicenter cohort of COVID-19 patients treated with V-V ECMO and evaluate the performance of several clinical scores to predict 30-day survival.
Efficacy of Multidisciplinary Team Approach with Extracorporeal Membrane Oxygenation for COVID-19 in Low Volume ECMO Center
Veno-venous extracorporeal membrane oxygenation (VV ECMO) is an effective and proven adjunct support for various severe respiratory failure requiring invasive mechanical ventilation and cardiovascular support. In response to the rapidly increasing number of COVID-19 patients in Japan, we launched an ECMO support team comprised of multidisciplinary experts including physicians, nurses, perfusionists, and bioethicists in preparation for the threat of a pandemic.
Six-Month Survival After Extracorporeal Membrane Oxygenation for Severe COVID-19
The present findings suggested that about half of adult patients with severe COVID-19–related ARDS can be managed successfully with ECMO with sustained results at six months. Decreased arterial pH before ECMO was associated significantly with early mortality. Therefore, the authors hypothesized that initiation of ECMO therapy before severe metabolic derangements subset may improve survival rates significantly in these patients. These results should be viewed in the light of a strict patient selection policy and may not be replicated in patients with advanced age or multiple comorbidities.
VV ECMO Strategies for COVID-19, A Single Center Experience
Topics covered in this webinar included patient selection and management, cannulation preference, extracorporeal circuit design, staffing models and personal protective equipment.
Extracorporeal Membrane Oxygenation Support in Severe COVID-19
The early outcomes presented here suggest that the judicious use of ECMO support in severe COVID-19 may be clinically beneficial.
EACTA/SCA Recommendations for the Cardiac Anesthesia Management of Patients with Suspected or Confirmed COVID-19 Infection: An Expert Consensus from the European Association of Cardiothoracic Anesthesiology and Society of Cardiovascular Anesthesiologists with the endorsement from the Chinese Society of Cardiothoracic and Vascular Anesthesiology
Our document should be the basis of future Task Forces to develop a more comprehensive consensus considering new evidence uncovered during the COVID-19 pandemic.
Utilization of Thromboelastogram and Inflammatory Markers in the Management of Hypercoagulable State in Patients with COVID-19 Requiring ECMO Support
The results of this case report show successful management of a hypercoagulable state among COVID-19 patients requiring ECMO support by utilization of inflammatory markers and TEG.
Complete Aortic Thrombosis in SARS-Cov-2 Infection
COVID-19 infection due to the SARS-CoV-2 virus has shown to be associated with a hypercoagulable state.
Observational Study of Thrombosis and Bleeding In COVID-19 VV ECMO Patients
We observed a high prevalence of VTE and a significant number of hemorrhages in these severely ill patients with COVID-19 requiring veno-venous ECMO support.