Viscoelastic Coagulation Monitor as a Novel Device to Assess Coagulation at the Bedside. A Single-Center Experience During the COVID-19 Pandemic
In conclusion, VCM provided reliable results in COVID-19 patients and was easy to perform with minimal training at the bedside.
Early Outcomes After Lung Transplantation for Severe COVID-19: A Series of the First Consecutive Cases from Four Countries
We aimed to describe the course of disease and early post-transplantation outcomes in critically ill patients with COVID-19 who failed to show lung recovery despite optimal medical management and were deemed to be at imminent risk of dying due to pulmonary complications.
ECMO Combined with Prone Positioning Strategies In COVID-19 Respiratory Distress Syndrome
Previous evidence from similar patient populations proved that carefully selected patients with severe ARDS who did not benefit from conventional treatment might be successfully supported with Veno-Venous extracorporeal membrane oxygenation (V-V ECMO). We now share the case reports of COVID-19 patients with ECMO combined prone position strategies.
Insight into ECMO, Mortality and ARDS: A Nationwide Analysis of 45,647 ECMO Runs
The choice of support mode depends largely on the indication. Patients with respiratory failure are predominantly treated with a venovenous (VV) approach. We hypothesized that mortality in Germany in ECLS therapy did not differ from previously reported literature
Extracorporeal Life Support in COVID-19-related Acute Respiratory Distress Syndrome – a EuroELSO international survey
ECLS has been utilized successfully during the COVID‐19 pandemic to stabilize CARDS patients in hypoxemic or hypercapnic lung failure. Age and multimorbidity limited the use of ECLS. Triage situations were rarely a concern. ECLS providers stated that patients with severe COVID‐19 benefitted from ECLS.
Association of D-dimer and Fibrinogen With Hypercoagulability in COVID-19 Requiring Extracorporeal Membrane Oxygenation
In critically ill patients with COVID-19 treated with ECMO, D-dimer concentration had an inverse relationship with degree of hypercoagulability as measured by TEG MA. D-dimer elevation may potentially reflect hemostatic perturbation in patients on ECMO or the severity of COVID-19 related sepsis rather than designate patients likely to benefit from anticoagulation. Fibrinogen concentration may represent a more useful marker of hypercoagulability in this population.
Impact of the Influenza Vaccine on COVID-19 Infection Rates and Severity
With a unique influenza season occurring in the midst of a pandemic, there is interest in assessing the role of the influenza vaccine in COVID-19 susceptibility and severity.
Perioperative Management of COVID-19 Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass
The following report will recommend perioperative guidance in patient management to include safety precautions for the heart team, the conduct of extracorporeal circulation and related equipment, and covering the early period in intensive care in the context of the current pandemic.
Survival of Pregnant Coronavirus Patient on Extracorporeal Membrane Oxygenation
She was discharged to home and gave birth to a healthy baby girl at 39 weeks’ gestation. Using VV-ECMO, this patient and her fetus survived acute hypoxemic respiratory failure due to COVID-19.
Use of ECMO in Patients With Coronavirus Disease 2019: Does the Evidence Suffice?
In conclusion, these authors recommend ECMO use in COVID-19 but with caution and in compliance with current guidelines. While evidence advocating ECMO use in COVID-19 is not substantial, ongoing studies may provide new insight in ECMO use in COVID-19 patients in critical cases. To ensure optimal patient care, a case-by-case approach should be implemented, with risk-benefit analysis conducted for each patient
Hemoadsorption Eliminates Remdesivir from the Circulation: Implications for the Treatment of COVID-19
Both antiviral treatment with remdesivir and hemoadsorption using a CytoSorb® adsorption device are applied in the treatment of severe COVID-19. The CytoSorb® adsorber consists of porous polymer beads that adsorb a broad range of molecules, including cytokines but also several therapeutic drugs. In this study, we evaluated whether remdesivir and its main active metabolite GS-441524 would be adsorbed by CytoSorb®.
Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit: The INSPIRATION Randomized Clinical Trial
Among patients admitted to the ICU with COVID-19, intermediate-dose prophylactic anticoagulation, compared with standard-dose prophylactic anticoagulation, did not result in a significant difference in the primary outcome of a composite of adjudicated venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days.
Outcomes of Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome due to COVID-19: The Lessons Learned from the First Wave of COVID-19
Extracorporeal membrane oxygenation (ECMO) has been used as a refractory treatment for acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (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.
Integral Use of Thromboelastography With Platelet Mapping to Guide Appropriate Treatment, Avoid Complications, and Improve Survival of Patients With Coronavirus Disease 2019–Related Coagulopathy
The primary aim was to evaluate if algorithm-guided thromboelastography with platelet mapping could better characterize an individual’s coronavirus disease 2019-relatedcoagulopathic state and, secondarily, improve outcomes.
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.