Extracorporeal membrane oxygenation in COVID-19 compared to other etiologies of acute respiratory failure: A single-center experience

Yaqoob, Hamid; Greenberg, Daniel J.; Huang, Lawrence; Henson, Theresa; Pitaktong, Areen; Peneyra, Daniel; Spencer, Philip; Malekan, Ramin; Goldberg, Joshua; Kai, Masashi; Ohira, Suguru; Wang, Zhen; Murad, M Hassan; Chandy, Dipak; Epelbaum, Oleg

doi:10.1016/j.hrtlng.2022.10.003

Cited by 7 publications

(7 citation statements)

References 30 publications

(39 reference statements)

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“…Yaqoob et al compared the clinically important outcomes in recipients of ECMO for COVID-19 to those with ARDS of other etiologies. 13 Survival to hospital discharge was not different between the two groups (33% vs 50%, p = 0.255). However, the proportion of patients who received ECMO support >30 days was higher in the COVID-19 ARDS group (69% vs 17%, p = 0.001).…”

Section: Discussionmentioning

confidence: 85%

Outcome of Patients on Prolonged V-V ECMO at a Tertiary Care Center in India

Chakraborty,

Goel,

Goel

2023

Indian Journal of Critical Care Medicine

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A bstract Introduction Extracorporeal membrane oxygenation (ECMO) is a life-support system that provides cardiopulmonary support. With recent advances, the duration of ECMO has increased but data on the outcomes of prolonged V-V ECMO are limited and inconsistent. Materials and methods It is a retrospective observational study done at a tertiary care center in Kolkata to study the outcome of patients receiving prolonged V-V ECMO defined as >14 days. Observation A total of 22 patients received prolonged ECMO support. Fifteen patients (68.2%) had severe coronavirus disease-2019 (COVID-19). The mean duration of invasive mechanical ventilation (IMV) before ECMO was 5 days. Baseline PaO 2 /FiO 2 (p/f) ratio was 82 and Murray score was 3.5. The mean duration of ECMO support was 27.18 days (SD: 11.59). Five patients (22.7%) had minor bleeding and one patient had oxygenator failure. Survival at hospital discharge was seven patients (31.8%). Conclusion Duration of ECMO support alone should not represent a basis for decision making to decide futility or continuation of ECMO support. Prolonged ECMO in acute respiratory distress syndrome (ARDS) has minor complications and can lead to recovery in almost one-third of the patients. How to cite this article Goel K, Chakraborty A, Goel A. Outcome of Patients on Prolonged V-V ECMO at a Tertiary Care Center in India. Indian J Crit Care Med 2023;27(11):790–794.

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Section: Discussionmentioning

confidence: 85%

Outcome of Patients on Prolonged V-V ECMO at a Tertiary Care Center in India

Chakraborty,

Goel,

Goel

2023

Indian Journal of Critical Care Medicine

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“…Regarding the use of ECMO in ARDS outside of the COVID-19 context, Yaqoob et al8 conducted a retrospective study comparing the use of ECMO for ARDS due to COVID-19 and other causes, including influenza. This study was conducted at Westchester Medical Center (WMC) in New York and consisted of 54 patients (36 in the COVID ECMO group and 18 in the non-COVID ECMO group).…”

Section: Resultsmentioning

confidence: 99%

An Integrative Review

Tam,

Norman,

Chen

2024

Critical Care Nursing Quarterly

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The onset of the COVID-19 pandemic has led to an increased use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS); however, there are ongoing concerns about its associated risks and benefits, making a comprehensive understanding vital for clinical decision-making. This review aims to evaluate the efficacy, risks, and practical implications of ECMO as a therapeutic intervention in severe ARDS secondary to COVID-19. The results indicate that ECMO is a key therapeutic intervention for managing severe COVID-19, but due to its associated risks and resource constraints, its application needs careful consideration. Nurse practitioners need to acquire specialized skills to manage ECMO and stay updated with ongoing research and revised protocols. Given the potential for future virus mutations or pandemics, and finite resources, a multidisciplinary approach to ECMO therapy is necessary. Careful patient selection, strategic resource allocation, and continuous education are pivotal elements for improved patient outcomes.

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“…Extensive research has since revealed that COVID-19 may lead to a range of complications, with respiratory issues being the most common and severe [ 2 ]. Acute respiratory failure resulting from COVID-19 infection frequently necessitates the use of invasive mechanical ventilation, and extracorporeal membrane oxygenation (ECMO) has emerged as a potentially life-saving intervention [ 3 - 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, during the COVID-19 pandemic, the limited availability of ECMO resources has challenged healthcare professionals. This scarcity has necessitated difficult decisions regarding patient selection [ 3 , 4 , 8 - 10 ]. Thus, it is crucial to identify the factors associated with patient outcomes and mortality in this context.…”

Section: Introductionmentioning

confidence: 99%

“…Existing research has primarily been focused on patients with COVID-19 who are supported by veno-venous ECMO http://www.jchestsurg.org JCS [3][4][5]8,9,11,12]. However, some patients with COVID-19 infection not only have impaired lung function but also require circulatory support, due to conditions such as right ventricular (RV) failure and septic shock.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Extracorporeal Membrane Oxygenation in COVID-19: A Single-Center Study

Kim,

Lim,

et al. 2023

J Chest Surg

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Background Coronavirus disease 2019 (COVID-19) can lead to acute respiratory failure, which frequently necessitates invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO). However, the limited availability of ECMO resources poses challenges to patient selection and associated decision-making. Consequently, this retrospective single-center study was undertaken to evaluate the characteristics and clinical outcomes of patients with COVID-19 receiving ECMO. Methods Between March 2020 and July 2022, 65 patients with COVID-19 were treated with ECMO and were subsequently reviewed. Patient demographics, laboratory data, and clinical outcomes were examined, and statistical analyses were performed to identify risk factors associated with mortality. Results Of the patients studied, 15 (23.1%) survived and were discharged from the hospital, while 50 (76.9%) died during their hospitalization. The survival group had a significantly lower median age, at 52 years (interquartile range [IQR], 47.5–61.5 years), compared to 64 years (IQR, 60.0–68.0 years) among mortality group (p=0.016). However, no significant differences were observed in other underlying conditions or in factors related to intervention timing. Multivariable analysis revealed that the requirement of a change in ECMO mode (odds ratio [OR], 366.77; 95% confidence interval [CI], 1.92–69911.92; p=0.0275) and the initiation of continuous renal replacement therapy (CRRT) (OR, 139.15; 95% CI, 1.95–9,910.14; p=0.0233) were independent predictors of mortality. Conclusion Changes in ECMO mode and the initiation of CRRT during management were associated with mortality in patients with COVID-19 who were supported by ECMO. Patients exhibiting these factors require careful monitoring due to the potential for adverse outcomes.

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Extracorporeal membrane oxygenation in COVID-19 compared to other etiologies of acute respiratory failure: A single-center experience

Cited by 7 publications

References 30 publications

Outcome of Patients on Prolonged V-V ECMO at a Tertiary Care Center in India

Outcome of Patients on Prolonged V-V ECMO at a Tertiary Care Center in India

An Integrative Review

Outcomes of Extracorporeal Membrane Oxygenation in COVID-19: A Single-Center Study

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