Extracorporeal Membrane Oxygenation Retrieval in Coronavirus Disease 2019: A Case-Series of 19 Patients Supported at a High-Volume Extracorporeal Membrane Oxygenation Center

Riera, Jordi; Argudo, Eduard; Martínez-Martínez, María; García, Sandra Banderas; García-de-Acilu, Marina; Santafé, Manel M.; Díaz, Cándido; Cortina, Alexandra; Bonilla, Camilo; Pacheco, Andrés; Resta, Paula; Palmer, Neiser; Castro, Miguel Ángel; Ferrer, Ricard

doi:10.1097/cce.0000000000000228

Cited by 16 publications

(14 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the middle-income country circumstances and the low volume of patients of the ECMO program, outcomes are comparable to international series. ECMO survival and survival to discharge was 66% and 50%, respectively 22,23,24 .…”

Section: Discussionmentioning

confidence: 97%

Clinical characteristics of critically ill patients with COVID-19

Bisso

Huespe

Lockhart

et al. 2020

Preprint

View full text Add to dashboard Cite

ObjectiveDescribe the clinical and respiratory characteristics of critical patients with coronavirus disease 2019 (COVID-19).DesignObservational and retrospective study over 6 months.SettingIntensive care unit (ICU) of a high complexity hospital in Buenos Aires, Argentina.PatientsPatients older than 18 years with laboratory-confirmed COVID-19 by reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2 were included in the study.Variables of interestDemographic characteristics such as sex and age, comorbidities, laboratory results, imaging results, ventilatory mechanics data, complications, and mortality were recorded.ResultsA total of 168 critically ill patients with COVID-19 were included. 66% were men with a median age of 65 years (58-75. 79.7% had at least one comorbidity. The most frequent comorbidity was arterial hypertension, affecting 52.4% of the patients. 67.9 % required invasive mechanical ventilation (MV), and no patient was treated with non-invasive ventilation. Most of the patients in MV (73.7%) required neuromuscular blockade due to severe hypoxemia. 36% of patients were ventilated in the prone position. The length of stay in the ICU was 13 days (6-24) and the mortality in the ICU was 25%.ConclusionsIn this study of critical patients infected by SARS-CoV-2 in a high-complexity hospital, the majority were comorbid elderly men, a large percentage required invasive mechanical ventilation, and ICU mortality was 25%.

show abstract

Section: Discussionmentioning

confidence: 97%

Clinical characteristics of critically ill patients with COVID-19

Bisso

Huespe

Lockhart

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In this regard, and in agreement with previous results [ 7 ], we found that patients supported at centers with a high case volume had a lower mortality. The recommendation to concentrate cases at high-volume centers should include the capability to retrieve the sickest patients admitted in hospitals that do not have access to this technique [ 8 , 9 ]. Not surprisingly, in our series, patients who were retrieved had lower hospital mortality, a finding that reinforces the idea that attention should be centralized.…”

mentioning

confidence: 99%

Risk factors for mortality in patients with COVID-19 needing extracorporeal respiratory support

et al. 2021

Self Cite

View full text Add to dashboard Cite

“…More recent studies reflecting modern practices and technologies have found similar survival rates for patients transported on ECMO; however, complication rates were decreased. [4][5][6][7][8] Although the use of ECMO in acute respiratory distress syndrome (ARDS) has been widely established, the role of ECMO in patients with COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is an ongoing area of exploration. Initial studies have shown the incidence of ARDS varies from 14.8% to 42%, and carries with it a mortality rate of 74-88%.…”

mentioning

confidence: 99%

Mobile Extracorporeal Membrane Oxygenation for Covid-19 Does Not Pose Extra Risk to Transport Team

et al. 2021

View full text Add to dashboard Cite

for the Covid-19 CritiCaL Care ConSortium Previous experience has shown that transporting patients on extracorporeal membrane oxygenation (ECMO) is a safe and effective mode of transferring critically ill patients requiring maximum mechanical ventilator support to a quaternary care center. The coronavirus disease 2019 (COVID-19) pandemic posed new challenges. This is a multicenter, retrospective study of 113 patients with confirmed severe acute respiratory syndrome coronavirus 2, cannulated at an outside hospital and transported on ECMO to an ECMO center. This was performed by a multidisciplinary mobile ECMO team consisting of physicians for cannulation, critical care nurses, and an ECMO specialist or perfusionist, along with a driver or pilot. Teams practised strict airborne contact precautions with eyewear while caring for the patient and were in standard Personal Protective Equipment. The primary mode of transportation was ground. Ten patients were transported by air. The average distance traveled was 40 miles (SD ±56). The average duration of transport was 133 minutes (SD ±92).When stratified by mode of transport, the average distance traveled for ground transports was 36 miles (SD ±52) and duration was 136 minutes (SD ±93). For air, the average distance traveled was 66 miles (SD ±82) and duration was 104 minutes (SD ±70). There were no instances of transportrelated adverse events including pump failures, cannulation complications at outside hospital, or accidental decannulations or dislodgements in transit. There were no instances of the transport team members contracting COVID-19 infection within 21 days after transport. By adhering to best practices and ACE precautions, patients with COVID-19 can be safely cannulated at an outside hospital and transported to a quaternary care center without increased risk to the transport team.

show abstract

Extracorporeal Membrane Oxygenation Retrieval in Coronavirus Disease 2019: A Case-Series of 19 Patients Supported at a High-Volume Extracorporeal Membrane Oxygenation Center

Abstract: Supplemental Digital Content is available in the text.

Cited by 16 publications

References 14 publications

Clinical characteristics of critically ill patients with COVID-19

Clinical characteristics of critically ill patients with COVID-19

Risk factors for mortality in patients with COVID-19 needing extracorporeal respiratory support

Mobile Extracorporeal Membrane Oxygenation for Covid-19 Does Not Pose Extra Risk to Transport Team

Contact Info

Product

Resources

About