Role of extracorporeal membrane oxygenation in COVID‐19: A systematic review

Haiduc, Ana Alina; Alom, Samiha; Melamed, Naomi; Harky, Amer

doi:10.1111/jocs.14879

Cited by 52 publications

(51 citation statements)

References 42 publications

(116 reference statements)

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“… 2 The Extracorporeal Life Support Organization (ELSO) has released a consensus document on the use of ECMO for COVID-19. 4 Indications and contraindications for the use of ECMO have been listed in this guideline. The guideline recommends ECMO to be offered in experienced centers rather than compromise existing infrastructure in non-ECMO centers.…”

Section: E Xtracorporeal M Embrane mentioning

confidence: 99%

Critical Care for COVID-19 Affected Patients: Updated Position Statement of the Indian Society of Critical Care Medicine

Mehta

Chaudhry

Abraham

et al. 2020

Indian Journal of Critical Care Medicine

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A bstract The management of coronavirus disease-2019 (COVID-19) is witnessing a change as we learn more about the pathophysiology and the severity of the disease. Several randomized controlled trials (RCTs) and meta-analysis have been published over the last few months. Several interventions and therapies which showed promise in the initial days of the pandemic have subsequently failed to show benefit in well-designed trials. Understanding of the methods of oxygen delivery and ventilation have also evolved over the past few months. The Indian Society of Critical Care Medicine (ISCCM) has reviewed the evidence that has emerged since the publication of its position statement in May and has put together an addendum of updated evidence. How to cite this article: Mehta Y, Chaudhry D, Abraham OC, Chacko J, Divatia J, Jagiasi B, et al . Critical Care for COVID-19 Affected Patients: Position Statement of the Indian Society of Critical Care Medicine. Indian J Crit Care Med 2020;24(Suppl 5):S225–S230.

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Section: E Xtracorporeal M Embrane mentioning

confidence: 99%

Critical Care for COVID-19 Affected Patients: Updated Position Statement of the Indian Society of Critical Care Medicine

Mehta

Chaudhry

Abraham

et al. 2020

Indian Journal of Critical Care Medicine

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“…Hereby, temporary MCS remains the ultimate symptomatic treatment for acute cardiovascular and lung failure whenever conservative and medical treatment fails to (re‐)establish sufficient cardiopulmonary function in cases of severe COVID‐19. Isolated VV‐ECMO allows for safe oxygenation and decarboxylation, whereas venoarterial ECLS ensures sufficient circulation in cases of cardiogenic shock 20 . Specialized ECLS centers will take over a particular responsibility these times by indicating and treating critically ill COVID‐19 patients with complicated courses.…”

Section: Strategies and Preparations To Combat The Covid‐19 Pandemic mentioning

confidence: 99%

The role of mechanical circulatory support in COVID 19 patients

et al. 2020

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The role of mechanical circulatory support in COVID 19 patientsThe onset and impact of coronavirus disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has left dramatic effects on all aspects of life. Social life, economy, and medical care face challenge not seen before. With regard to end-stage heart failure and mechanical circulatory support (MCS), challenges, strategies, and preparations are addressed within this editorial.Indeed, MCS has become a true story of success, particularly following recent innovations in the last decade. Both, durable and temporary devices have changed the way we treat heart failure nowadays remarkably. [1][2][3][4] Nevertheless, the COVID-19 pandemic does not spare MCS at all. Instead, COVID-19 and MCS affect one another in two ways. Since we know that COVID-19 infection is not limited to the respiratory tract, but may also affect the heart, the matter of need for MCS in COVID-19 associated heart failure has arisen. 5 At the same time, the pandemic itself has caused significant limitations and restrictions to medical health systems as never before in modern times. Medical professionals and intensive-care resources have been and are still partially blocked for the treatment of patients suffering from severe COVID-19 infection. The focus of medical treatment altered towards diagnosis and treatment of COVID-19 and yet, the complete impact of the pandemic is unclear. As a result, elective admissions and surgery decreased consecutively and overall discomfiture and uncertainty in patients and healthcare professionals increased at the same time. Hence, outpatient care of permanent left ventricular assist device (LVAD) patients and immediate medical professional staff to patient interaction suffered, too. | COVID-19 AND CARDIAC INVOLVEMENTCOVID-19 is caused by SARS-CoV-2 and implicates the respiratory tract to be the main organ system affected by the virus. Notwithstanding, cardiovascular complications, including heart failure, may affect a large part of patients. [6][7][8] Acute virus-mediated myocardial injury and systemic inflammation may aggravate a pre-existing cardiac condition. Furthermore, reports have been published associating COVID-19 with thromboembolism. 9 However, with the immediate association of mechanical support and infectious disease, the role of MCS in this greater context of COVID-19 needs to be addressed.

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“…(9)(10)(11) While its efficacy in lowering mortality rates is still debated, ECMO is now a common treatment for patients with refractory ARDS. (11)(12)(13)(14) Despite some recent publications, (15)(16)(17) there remains a lack of evidence documenting the overall efficacy of ECMO in treating ARDS due to COVID-19. The purpose of this paper is to share our experience using ECMO as a bridge to recovery for patients with ARDS due to COVID-19 during the first wave of the COVID-19 pandemic in our area.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome due to COVID-19, lessons learned from the first wave of COVID 19

Blazoski

Baram

Hirose

2021

Preprint

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Introduction: Extracorporeal membrane oxygenation (ECMO) has been used as a refractory treatment for acute respiratory distress syndrome (ARDS) due to COVID-19, but there has been little evidence of its efficacy. We conducted this study to share our experience using ECMO as a bridge to recovery for ARDS due to COVID-19. Methods: All adult patients who were placed on ECMO for ARDS due to COVID -19 between April 2020 and June 2020 (during the first wave of COVID-19) were identified. The clinical characteristics and outcomes of these patients were analyzed with a specific focus on the differences between patients who survived to hospital discharge and those who did not. Results: 20 COVID-19 patients were included in this study. All patients were placed on veno-veno ECMO. Comparing between survivors and non-survivors, older age was associated with hospital mortality (p=0.02). The following complications were observed: renal failure requiring renal replacement therapy (35%, n=7), bacteremia during ECMO (20%, n=4),coinfection with bacterial pneumonia (15%, n=3), cannula site bleeding (15%, n=3), stroke (10%, n=2), gastrointestinal bleeding (10%, n=2), and liver failure (5%, n=1). The complications associated with patient mortality were culture positive septic shock (p=0.01), culture-negative systemic inflammatory response syndrome (p=0.01), and renal failure (p=0.01). The causes of death were septic shock (44%, n=4), culture-negative systemic inflammatory response syndrome (44%, n=4), and stroke (11%, n=1). Conclusions: Based on our experience, ECMO can improve refractory ARDS due to COVID-19 in select patients. Proper control of bacterial infections during COVID-19 immunomodulation therapy may be critical to improving survival.

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Role of extracorporeal membrane oxygenation in COVID‐19: A systematic review

Cited by 52 publications

References 42 publications

Critical Care for COVID-19 Affected Patients: Updated Position Statement of the Indian Society of Critical Care Medicine

Critical Care for COVID-19 Affected Patients: Updated Position Statement of the Indian Society of Critical Care Medicine

The role of mechanical circulatory support in COVID 19 patients

Outcomes of Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome due to COVID-19, lessons learned from the first wave of COVID 19

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