Essential Topics in the Management of Venovenous Extracorporeal Membrane Oxygenation in COVID-19 Acute Respiratory Distress Syndrome
Management of mechanical circulatory support in COVID-19 ARDS requires a highly resourced multidisciplinary ICU team and the ability to nimbly develop protocols for care for this new patient population. Here the authors discuss some unique aspects of care using VV ECMO management in COVID-19 ARDS.
Nine Lessons Learned From the COVID-19 Pandemic for Improving Hospital Care and Health Care Delivery
Although there is much to debate about the national public health response to COVID-19, we focus on the lessons learned through COVID-19 that we believe have applicability for improving hospital care in the future. The growth of telehealth has been covered elsewhere. We present 9 other lessons for improving hospital care and health care delivery.
Extracorporeal Membrane Oxygenation for COVID-19: Updated 2021 Guidelines from the Extracorporeal Life Support Organization
Given the paucity of available data when prior ECMO guidelines were published, this guideline has been created to summarize currently available literature and offer recommendations to update select areas within the previous guidelines. This document will focus on care specific to COVID-19 patients receiving ECMO and recommended alterations in the utilization of ECMO during a pandemic. We recommend referral to existing guidelines for general ECMO practices.
Can Heparin-Coated ECMO Cannulas Induce Thrombocytopenia in COVID-19 Patients?
Careful consideration of anticoagulant therapy and ECMO circuit, as well as routine HIT antibody testing, may prevent a fatal course in ECMO-supported COVID-19 patients.
The Assessment of Patients Undergoing Cardiac Surgery for Covid-19: Complications Occurring During Cardiopulmonary Bypass
The present study has shown that patients undergoing cardiac surgery with CPB who test positive for COVID-19 have higher CPB complication rate than those who test negative.
The Ongoing Impact of COVID-19 on Adult Cardiac Surgery and Suggestions for Safe Continuation Throughout the Pandemic: A Review of Expert Opinions
This paper suggests a ‘CARDIO’ approach for reintroducing elective procedures: ‘Care, Assess, Re-Evaluate, Develop, Implement, Overcome’; prioritising the mental and physical health of the workforce, learning from and sharing experiences and objectively prioritising patients to improve case load.
Extracorporeal Multiorgan Support Including CO2-Removal with the Advanced Organ Support (ADVOS) System for COVID-19: A Case Report
Irrespective of the outcome we conclude that extracorporeal CO2 removal and multiorgan-support were feasible in this COVID-19-patient. Combined and less invasive approaches such as ADVOS might be considered in old-age-COVID-19 patients with MOF.
Multi-institutional Analysis of 100 Consecutive Patients with COVID-19 and Severe Pulmonary Compromise Treated with Extracorporeal Membrane Oxygenation: Outcomes and Trends Over Time
Extracorporeal membrane oxygenation may facilitate salvage and survival of selected critically ill patients with COVID-19. Survivors tend to be younger. Substantial variation exists in the drug treatment of COVID-19, but ECMO offers a reasonable rescue strategy.
SARS-CoV-2 Leakage From the Gas Outlet Port During Extracorporeal Membrane Oxygenation for COVID-19
In conclusion, SARS-CoV-2 could leak to the gas outlet port of the ECMO circuit through silicone-coated polypropylene membranes during ECMO support of critically ill COVID-19 patients.
Extracorporeal Membrane Oxygenation Network Organisation and Clinical Outcomes During the COVID-19 Pandemic in Greater Paris, France: A Multicentre Cohort Study
Beyond associations with similar factors to those reported on ECMO for non-COVID-19 ARDS, 90-day survival among ECMO-assisted patients with COVID-19 was strongly associated with a centre’s experience in venovenous ECMO during the previous year. Early ECMO management in centres with a high venovenous ECMO case volume should be advocated, by applying centralisation and regulation of ECMO indications, which should also help to prevent a shortage of resources.
Anticoagulation and In-Hospital Mortality From Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
Our findings support the optimal efficacy and safety profiles of prophylactic dose AC in hospitalized COVID-19 patients.
Literature-Based Considerations Regarding Organizing and Performing Cardiac Surgery Against the Backdrop of the Coronavirus Pandemic
There is little evidence on the strategies to organize cardiac surgery in the Covid-19 pandemic. Most authors agree on reducing elective operations based on patients’ clinical condition and the status of the Covid-19 pandemic. Admission screenings and the use of percutaneous or minimally invasive approaches should be preferred to reduce in-hospital stays.
Thromboembolic and Bleeding Events in COVID-19 Patients receiving Extracorporeal Membrane Oxygenation
This study describes the incidences of TEE and BE in critically ill COVID-19 patients treated with ECMO. The most common adverse event during ECMO support was bleeding, which occurred at a comparable rate to non-COVID-19 patients treated with ECMO.
ECMO Assistance during Mechanical Ventilation: Effects Induced on Energetic and Haemodynamic Variables
The new modules of the systemic circulation and ECMO support allowed the study of the effects induced by concomitant mechanical ventilation and circulatory support. Based on our clinical experience during the COVID-19 pandemic, numerical simulations may help clinicians with data analysis and treatment optimisation of patients requiring both mechanical ventilation and circulatory support.
Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome: How Do We Expand Capacity in the COVID-19 Era?
As cases soar, more people require ECMO support, and triaged resource allocation becomes a reality: strategies to expand capacity are even more necessary.
Cardiac Surgery Outcome During the COVID-19 Pandemic: A Retrospective Review of the Early Experience in Nine UK Centres
To mitigate against the risks of Covid-19, particularly the post-operative burden, robust and effective pre-surgery diagnosis protocols alongside effective strategies to maintain a Covid-19 free environment are needed. Dedicated cardiac surgery hubs could be valuable in achieving safe and continual delivery of cardiac surgery.
Hypercoagulopathy, Acquired Coagulation Disorders and Anticoagulation Before, During and After Extracorporeal Membrane Oxygenation in COVID-19: A Case Series
Coronavirus-induced coagulopathy and bleeding disorders during vvECMO cannot be discriminated via ‘routine’ coagulation tests. Precise and specific analyses followed by the appropriate treatment of coagulation disorders may help us develop tailored therapeutic concepts to better manage the phases described above.
Hemoadsorption Eliminates Remdesivir from the Circulation: Implications for the Treatment Of COVID-19
Remdesivir and its main active metabolite GS‐441524 are rapidly eliminated from the perfusate by the CytoSorb® adsorber device in vitro. This should be considered in patients for whom both therapies are indicated, and simultaneous application should be avoided. In general, plasma levels of therapeutic drugs should be closely monitored under concurrent CytoSorb® therapy.
Extracorporeal Membrane Oxygenation in Patients With COVID-19: An International Multicenter Cohort Study
No significant differences in outcomes were found between COVID-19 patients on ECMO and non-COVID-19 ARDS patients on ECMO. This suggests that ECMO could be considered as a supportive therapy in case of refractory respiratory failure in COVID-19.
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.