Venovenous extracorporeal membrane oxygenation for patients with refractory coronavirus disease 2019 (COVID-19): Multicenter experience of referral hospitals in a large health care system

التفاصيل البيبلوغرافية
العنوان: Venovenous extracorporeal membrane oxygenation for patients with refractory coronavirus disease 2019 (COVID-19): Multicenter experience of referral hospitals in a large health care system
المؤلفون: Britton Blough, Chris Martin, J. Michael DiMaio, Emily Shih, Kara Monday, Robert L. Gottlieb, Anita Krueger, Jorge F. Velazco, Gary S. Schwartz, Timothy J. George, John J. Squiers, Jasjit K. Banwait, G.V. Gonzalez-Stawinski, Omar Hernandez, Ramachandra C Reddy, Dan M. Meyer, Jenelle Sheasby
المصدر: The Journal of Thoracic and Cardiovascular Surgery
بيانات النشر: Elsevier BV, 2020.
سنة النشر: 2020
مصطلحات موضوعية: VA, (venoarterial), Male, ARDS, LOS, (length of stay), medicine.medical_treatment, 030204 cardiovascular system & hematology, law.invention, Tertiary Care Centers, 0302 clinical medicine, Interquartile range, law, Fraction of inspired oxygen, Acute care, ARDS, (acute respiratory distress syndrome), COPD, (chronic obstructive pulmonary disease), ALT, (alanine transaminase), Coronavirus (COVID-19), SD, (standard deviation), Middle Aged, Intensive care unit, ICU, (intensive care unit), Treatment Outcome, surgical procedures, operative, CRP, (C-reactive protein), VV, (venovenous), CI, (cardiac index), Disease Progression, LDH, (lactate dehydrogenase), Female, Cardiology and Cardiovascular Medicine, IL-6, (interleukin-6), INR, (international normalized ratio), Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Critical Care, ECMO, (extracorporeal membrane oxygenation), Article, Extracorporeal Membrane Oxygenation (ECMO), 03 medical and health sciences, Extracorporeal Membrane Oxygenation, WBC, (white blood cell count), Refractory, Extracorporeal membrane oxygenation, medicine, Humans, IQR, (interquartile range), Secondary Care Centers, Aged, Retrospective Studies, Mechanical ventilation, business.industry, Patient Acuity, COVID-19, medicine.disease, Survival Analysis, Acute Respiratory Distress Syndrome (ARDS), 030228 respiratory system, Emergency medicine, Surgery, business, Follow-Up Studies
الوصف: Background The benefit of extracorporeal membrane oxygenation (ECMO) for patients with severe acute respiratory distress from COVID-19 refractory to medical management and lung-protective mechanical ventilation has not been adequately determined. Methods We reviewed the clinical course of 37 patients with laboratory-confirmed SARS-CoV-2 infection supported by venovenous ECMO at four ECMO referral centers within a large healthcare system. Patient characteristics, progression of hemodynamics and inflammatory markers, and clinical outcomes were evaluated. Results The patients had median age of 51 years (interquartile range [IQR] 40-59), and 73% were male. Peak plateau pressures, vasopressor requirements, and arterial PaCO2 all improved with ECMO support. In our patient population, 24/37 patients (64.8%) survived to decannulation and 21/37 patients (56.8%) survived to discharge. Among patients discharged alive from the ECMO facility, 12 patients were discharged to a long-term acute care or rehabilitation facility, 2 were transferred back to the referring hospital for ventilatory weaning, and 7 were discharged directly home. For patients who were successfully decannulated, median length of time on ECMO was 17 days (IQR 10-33.5). Conclusions Venovenous ECMO represents a useful therapy for patients with refractory severe acute respiratory distress syndrome from COVID-19.
Graphical abstract
اللغة: English
تدمد: 0022-5223
DOI: 10.1016/j.jtcvs.2020.11.073
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b626dabf9e52a5aefc685e1928530f11
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....b626dabf9e52a5aefc685e1928530f11
قاعدة البيانات: OpenAIRE
الوصف
تدمد:00225223
DOI:10.1016/j.jtcvs.2020.11.073